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Wu CS, Hsu LY, Shen CY, Chen WJ, Wang SH. Validation of self-reported medical condition in the Taiwan Biobank. J Epidemiol 2024:JE20240110. [PMID: 39034108 DOI: 10.2188/jea.je20240110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND This study aimed to validate self-reported medical conditions in the Taiwan Biobank (TWBB), in which participants were inquired about 30 disease conditions, by comparing them with claims records from Taiwan's National Health Insurance (NHI) claims database. METHODS We identified 30 clinical diagnoses using ICD-CM codes from ambulatory and hospital claims within the NHI claims database, matching diseases included in the TWBB. The concordance between self-reports and claims records was evaluated using tetrachoric correlation to assess the correlation between binary variables. RESULTS A total of 131,834 participants aged 30-70 years with data from the TWBB and NHI records were included. Concordance analysis revealed tetrachoric correlations ranged from 0.420 (chronic obstructive pulmonary disease) to 0.970 (multiple sclerosis). However, several disorders exhibited lower tetrachoric correlations. The concordance was higher among those with higher education attainment, and lower among married individuals. CONCLUSION The concordance between self-reports in the TWBB and NHI claims records varied across clinical diagnoses, showing inconsistencies depending on participant characteristics. These findings underscore the need for further investigation, especially when these variables are crucial to research objectives. Integrating complementary databases such as clinical diagnoses, prescription records, and medical procedures can enhance accuracy through customized algorithms based on disease categories and participant characteristics and optimize sensitivity or positive predictive values to align with specific research objectives.
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Affiliation(s)
- Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
- Graduate Program of Data Science, National Taiwan University and Academia Sinica
| | - Chen-Yang Shen
- Institute of Biomedical Sciences, Academia Sinica
- College of Public Health, China Medical University
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
- Center for Neuropsychiatric Research, National Health Research Institutes
| | - Shi-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes
- Department of Medical Research, China Medical University Hospital, China Medical University
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DeBlois JP, London AS, Heffernan KS. Hypertension at the nexus of veteran status, psychiatric disorders, and traumatic brain injury: Insights from the 2011 Behavioral Risk Factor Surveillance System. PLoS One 2024; 19:e0298366. [PMID: 38498456 PMCID: PMC10947695 DOI: 10.1371/journal.pone.0298366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/24/2024] [Indexed: 03/20/2024] Open
Abstract
Variable military service-related experiences, such as combat exposure, psychiatric disorders (PD), and traumatic brain injuries (TBI), may differentially affect the likelihood of having health care professional-identified high blood pressure (i.e., hypertension). PURPOSE Compare the odds of self-reported hypertension among non-combat and combat veterans with and without PD/TBI to non-veterans and each other. METHODS We used data from men from the 2011 Behavioral Risk Factor Surveillance System and distinguished: non-veterans (n = 21,076); non-combat veterans with no PD/TBI (n = 3,150); combat veterans with no PD/TBI (n = 1,979); and veterans (combat and non-combat) with PD and/or TBI (n = 805). Multivariable, hierarchical logistic regression models included exogenous demographic, socioeconomic attainment and family structure, health behavior and conditions, and methodological control variables. RESULTS One-third of men reported having been told at least once by a medical professional that they had high blood pressure. Bivariate analyses indicated that each veteran group had a higher prevalence of self-reported hypertension than non-veterans (design-based F = 45.2, p<0.001). In the fully adjusted model, no statistically significant differences in the odds of self-reported hypertension were observed between non-veterans and: non-combat veterans without PD/TBI (odds ratio [OR] = 0.92); combat veterans without PD/TBI (OR = 0.87); veterans with PD and/or TBI (OR = 1.35). However, veterans with PD and/or TBI had greater odds of reporting hypertension than both combat and non-combat veterans without PD/TBI (p<0.05). DISCUSSION Military service-related experiences were differentially associated with a survey-based measure of hypertension. Specifically, veterans self-reporting PD and/or TBI had significantly higher odds of self-reporting hypertension (i.e., medical provider-identified high blood pressure).
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Affiliation(s)
- Jacob P. DeBlois
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States of America
| | - Andrew S. London
- Department of Sociology, Syracuse University, Syracuse, NY, United States of America
| | - Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States of America
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Liu H, Zhao Y, Qiao L, Yang C, Yang Y, Zhang T, Wu Q, Han J. Consistency between self-reported disease diagnosis and clinical assessment and under-reporting for chronic conditions: data from a community-based study in Xi'an, China. Front Public Health 2024; 12:1296939. [PMID: 38292908 PMCID: PMC10825002 DOI: 10.3389/fpubh.2024.1296939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Aims The current study aims to investigate the consistency between the surveyees' self-reported disease diagnosis and clinical assessment of eight major chronic conditions using community-based survey data collected in Xi'an, China in 2017. With a focus on under-reporting patients, we aim to explore its magnitude and associated factors, to provide an important basis for disease surveillance, health assessment and resource allocation, and public health decision-making and services. Methods Questionnaires were administered to collect self-reported chronic condition prevalence among the study participants, while physical examinations and laboratory tests were conducted for clinical assessment. For each of the eight chronic conditions, the sensitivity, specificity, under-reporting, over-reporting, and agreement were calculated. Log-binomial regression analysis was employed to identify potential factors that may influence the consistency of chronic condition reporting. Results A total of 2,272 participants were included in the analysis. Four out of the eight chronic conditions displayed under-reporting exceeding 50%. The highest under-reporting was observed for goiter [85.93, 95% confidence interval (CI): 85.25-86.62%], hyperuricemia (83.94, 95% CI: 83.22-84.66%), and thyroid nodules (72.89, 95% CI: 72.02-73.76%). Log-binomial regression analysis indicated that senior age and high BMI were potential factors associated with the under-reporting of chronic condition status in the study population. Conclusion The self-reported disease diagnosis by respondents and clinical assessment data exhibit significant inconsistency for all eight chronic conditions. Large proportions of patients with multiple chronic conditions were under-reported in Xi'an, China. Combining relevant potential factors, targeted health screenings for high-risk populations might be an effective method for identifying under-reporting patients.
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Affiliation(s)
- Haobiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yanru Zhao
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lichun Qiao
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Congying Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Ying Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Tianxiao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- National Anti-Drug Laboratory Shaanxi Regional Center, Xi'an, Shaanxi, China
| | - Qian Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jing Han
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China
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Caceres BA, Sharma Y, Levine A, Wall MM, Hughes TL. Investigating the Associations of Sexual Minority Stressors and Incident Hypertension in a Community Sample of Sexual Minority Adults. Ann Behav Med 2023; 57:1004-1013. [PMID: 37306778 PMCID: PMC10653588 DOI: 10.1093/abm/kaac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Sexual minority adults are at higher risk of hypertension than their heterosexual counterparts. Sexual minority stressors (i.e., unique stressors attributed to sexual minority identity) are associated with a variety of poor mental and physical health outcomes. Previous research has not tested associations between sexual minority stressors and incident hypertension among sexual minority adults. PURPOSE To examine the associations between sexual minority stressors and incident hypertension among sexual minority adults assigned female sex at birth. METHODS Using data from a longitudinal study, we examined associations between three sexual minority stressors and self-reported hypertension. We ran multiple logistic regression models to estimate the associations between sexual minority stressors and hypertension. We conducted exploratory analyses to determine whether these associations differed by race/ethnicity and sexual identity (e.g., lesbian/gay vs. bisexual). RESULTS The sample included 380 adults, mean age 38.4 (± 12.81) years. Approximately 54.5% were people of color and 93.9% were female-identified. Mean follow-up was 7.0 (± 0.6) years; during which 12.4% were diagnosed with hypertension. We found that a 1-standard deviation increase in internalized homophobia was associated with higher odds of developing hypertension (AOR 1.48, 95% Cl: 1.06-2.07). Stigma consciousness (AOR 0.85, 95% CI: 0.56-1.26) and experiences of discrimination (AOR 1.07, 95% CI: 0.72-1.52) were not associated with hypertension. The associations of sexual minority stressors with hypertension did not differ by race/ethnicity or sexual identity. CONCLUSIONS This is the first study to examine the associations between sexual minority stressors and incident hypertension in sexual minority adults. Implications for future studies are highlighted.
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Affiliation(s)
- Billy A Caceres
- Columbia University School of Nursing, 560 West 168th Street, Room 603, New York, NY 10032, USA
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA
| | - Yashika Sharma
- Columbia University School of Nursing, 560 West 168th Street, Room 603, New York, NY 10032, USA
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA
| | - Alina Levine
- Department of Biostatistics, Columbia Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
| | - Melanie M Wall
- Department of Biostatistics, Columbia Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
| | - Tonda L Hughes
- Columbia University School of Nursing, 560 West 168th Street, Room 603, New York, NY 10032, USA
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, 560 West 168th Street, New York, NY 10032, USA
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Kato AM, Kibone W, Okot J, Baruch Baluku J, Bongomin F. Self-Reported Hypertension and Associated Factors Among Adults in Butambala District, Central Uganda: A Community-Based Prevalence Study. Integr Blood Press Control 2023; 16:71-80. [PMID: 37965566 PMCID: PMC10642373 DOI: 10.2147/ibpc.s434230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023] Open
Abstract
Background The prevalence of hypertension (HTN) differs among regions and income groups, showing a substantial increase in low- and middle-income countries. The development of hypertension is modulated by modifiable lifestyle factors, and uncontrolled hypertension poses a risk for the onset of cardiovascular diseases. Objective To determine the community-level point-prevalence and factors associated with self-reported HTN among adults in Butambala district, central Uganda. Methods A community-based cross-sectional study was conducted among adults aged ≥18 years in Budde subcounty, central Uganda. Data on sociodemographic characteristics and behavior were collected using a semistructured questionnaire. Self-reported HTN was assessed using a single question: "Do you have high blood pressure?" Bivariate and multivariate logistic regression analyses were performed to identify predictors of self-reported HTN. Results A total of 565 participants (53.5% female) with a median age of 38 years (IQR: 26-52) were included in the study. The prevalence of self-reported hypertension was 18.9%. Factors independently associated with HTN were age 60 years or older (aOR: 2.9, 95% CI: 1.64-5.23, p<0.001), female sex (aOR: 3.3, 95% CI: 2.3-6.3, p<0.001), being widowed (aOR: 10.4, 95% CI: 1.25-87.14, p=0.03), secondary (aOR: 0.4, 95% CI: 0.20-0.85, p=0.016) and tertiary (aOR: 0.2, 95% CI: 0.09-0.64, p=0.005) education, unemployment (aOR: 3.0, 95% CI: 1.11-7.96, p=0.03), tobacco use (aOR: 2.9, 95% CI: 1.83-4.53, p<0.001), having had at least one blood pressure measurement during antenatal visit (aOR: 4.7, 95% CI: 1.97-11.33, p<0.001) or medical checkup (aOR: 10.7, 95% CI: 6.06-18. Conclusion We observed a high prevalence of self-reported HTN affecting approximately one in five participants. More efforts are required to enhance routine screening, health education, and accessibility to HTN services in rural areas, with a particular emphasis on implementing HTN prevention and control strategies to effectively reduce the prevalence of HTN.
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Affiliation(s)
- Alex Male Kato
- Department of Public Health, Gulu University, Gulu, Uganda
| | - Winnie Kibone
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jerom Okot
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Campbell E, Macey E, Shine C, Nafilyan V, Clark NC, Pawelek P, Ward I, Hughes A, Raleigh V, Banerjee A, Finning K. Sociodemographic and health-related differences in undiagnosed hypertension in the health survey for England 2015-2019: a cross-sectional cohort study. EClinicalMedicine 2023; 65:102275. [PMID: 38106553 PMCID: PMC10725049 DOI: 10.1016/j.eclinm.2023.102275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 12/19/2023] Open
Abstract
Background Hypertension is a leading cause of morbidity and mortality worldwide, yet a substantial proportion of cases are undiagnosed. Understanding the scale of undiagnosed hypertension and identifying groups most at risk is important to inform approaches to detection. Methods In this cross-sectional cohort study, we used data from the 2015 to 2019 Health Survey for England, an annual, cross-sectional, nationally representative survey. The survey follows a multi-stage stratified probability sampling design, involving a random sample of primary sampling units based on postcode sectors, followed by a random sample of postal addresses within these units. Within each selected household, all adults (aged ≥16 years) and up to four children, were eligible for participation. For the current study, individuals aged 16 years and over who were not pregnant and had valid blood pressure data were included in the analysis. The primary outcome was undiagnosed hypertension, defined by a measured blood pressure of 140/90 mmHg or above but no history of diagnosis. Age-adjusted prevalence of undiagnosed hypertension was estimated across sociodemographic and health-related characteristics, including ethnicity, region, rural-urban classification, relationship status, highest educational qualification, National Statistics Socio-Economic Classification (NS-SEC), Body Mass Index (BMI), self-reported general health, and smoking status. To assess the independent association between undiagnosed hypertension and each characteristic, we fitted a logistic regression model adjusted for sociodemographic factors. Findings The sample included 21,476 individuals, of whom 55.8% were female and 89.3% reported a White ethnic background. An estimated 30.7% (95% confidence interval 29.0-32.4) of men with hypertension and 27.6% (26.1-29.1) of women with hypertension were undiagnosed. Younger age, lower BMI, and better self-reported general health were associated with an increased likelihood of hypertension being undiagnosed for men and women. Living in rural areas and in regions outside of London and the East of England were also associated with an increased likelihood of hypertension being undiagnosed for men, as were being married or in a civil partnership and having higher educational qualifications for women. Interpretation Hypertension is commonly undiagnosed, and some of the groups that are at the lowest risk of hypertension are the most likely to be undiagnosed. Given the high lifetime risk of hypertension and its strong links with morbidity and mortality, our findings suggest a need for greater awareness of the potential for undiagnosed hypertension, including among those typically considered 'low risk'. Further research is needed to assess the impact of extending hypertension screening to lower-risk groups. Funding None.
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Affiliation(s)
- Emma Campbell
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Ellie Macey
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Chris Shine
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Vahé Nafilyan
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Nathan Cadogan Clark
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Piotr Pawelek
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Isobel Ward
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
| | - Andrew Hughes
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, SW1H 0EU, UK
| | - Veena Raleigh
- The King's Fund, 11–13 Cavendish Square, London, W1G 0AN, UK
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, 222 Euston Road, London, NW1 2DA, UK
| | - Katie Finning
- Office for National Statistics, Government Buildings, Cardiff Rd, Duffryn, Newport, NP10 8XG, UK
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Stevenson AC, Colley RC, Dasgupta K, Minaker LM, Riva M, Widener MJ, Ross NA. Neighborhood Fast-Food Environments and Hypertension in Canadian Adults. Am J Prev Med 2023; 65:696-703. [PMID: 37068598 DOI: 10.1016/j.amepre.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Hypertension is a leading cause of cardiovascular disease and premature death worldwide. Neighborhoods characterized by a high proportion of fast-food outlets may also contribute to hypertension in residents; however, limited research has explored these associations. This cross-sectional study assessed the associations between neighborhood fast-food environments, measured hypertension, and self-reported hypertension. METHODS Data from 10,700 adults living in urban areas were obtained from six Canadian Health Measures Survey cycles (2007-2019). Each participant's blood pressure was measured at a mobile clinic six times. Measured hypertension was defined as having an average systolic blood pressure ≥140 or a diastolic blood pressure ≥90 mm Hg or being on blood pressure-lowering medication. Participants were also asked whether they had been diagnosed with high blood pressure or whether they take blood pressure-lowering medication (i.e., self-reported hypertension). The proportion of fast-food outlets relative to the sum of fast-food outlets and full-service restaurants in each participant's neighborhood was obtained from the Canadian Food Environment Dataset, and analyses were conducted in 2022. RESULTS The mean proportion of fast-food outlets was 23.3% (SD=26.8%). A one SD increase in the proportion of fast-food outlets was associated with higher odds of measured hypertension in the full sample (OR=1.17, 95% CI=1.05, 1.31) and in sex-specific models (women: OR=1.14, 95% CI=1.01, 1.29; men: OR=1.21, 95% CI=1.03, 1.43). Associations between the proportion of fast-food outlets and self-reported hypertension were inconclusive. CONCLUSIONS Findings suggest that reducing the proportion of fast-food restaurants in neighborhoods may be a factor that could help reduce hypertension rates.
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Affiliation(s)
| | - Rachel C Colley
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Kaberi Dasgupta
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montréal, Quebec, Canada; McGill University Health Center, Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada; Center for Outcomes Research & Evaluation (CORE), McGill University Health Centre Research Institute, McGill University, Montréal, Quebec, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Mylene Riva
- Department of Geography, McGill University, Montréal, Quebec, Canada; Institute for Health and Social Policy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Michael J Widener
- Department of Geography & Planning, Faculty of Arts & Science, University of Toronto, Toronto, Ontario, Canada
| | - Nancy A Ross
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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Markoulli M, Ahmad S, Arcot J, Arita R, Benitez-Del-Castillo J, Caffery B, Downie LE, Edwards K, Flanagan J, Labetoulle M, Misra SL, Mrugacz M, Singh S, Sheppard J, Vehof J, Versura P, Willcox MDP, Ziemanski J, Wolffsohn JS. TFOS Lifestyle: Impact of nutrition on the ocular surface. Ocul Surf 2023; 29:226-271. [PMID: 37100346 DOI: 10.1016/j.jtos.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 04/28/2023]
Abstract
Nutrients, required by human bodies to perform life-sustaining functions, are obtained from the diet. They are broadly classified into macronutrients (carbohydrates, lipids, and proteins), micronutrients (vitamins and minerals) and water. All nutrients serve as a source of energy, provide structural support to the body and/or regulate the chemical processes of the body. Food and drinks also consist of non-nutrients that may be beneficial (e.g., antioxidants) or harmful (e.g., dyes or preservatives added to processed foods) to the body and the ocular surface. There is also a complex interplay between systemic disorders and an individual's nutritional status. Changes in the gut microbiome may lead to alterations at the ocular surface. Poor nutrition may exacerbate select systemic conditions. Similarly, certain systemic conditions may affect the uptake, processing and distribution of nutrients by the body. These disorders may lead to deficiencies in micro- and macro-nutrients that are important in maintaining ocular surface health. Medications used to treat these conditions may also cause ocular surface changes. The prevalence of nutrition-related chronic diseases is climbing worldwide. This report sought to review the evidence supporting the impact of nutrition on the ocular surface, either directly or as a consequence of the chronic diseases that result. To address a key question, a systematic review investigated the effects of intentional food restriction on ocular surface health; of the 25 included studies, most investigated Ramadan fasting (56%), followed by bariatric surgery (16%), anorexia nervosa (16%), but none were judged to be of high quality, with no randomized-controlled trials.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia.
| | - Sumayya Ahmad
- Icahn School of Medicine of Mt. Sinai, New York, NY, USA
| | - Jayashree Arcot
- Food and Health, School of Chemical Engineering, UNSW Sydney, Australia
| | - Reiko Arita
- Department of Ophthalmology, Itoh Clinic, Saitama, Japan
| | | | | | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Katie Edwards
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Judith Flanagan
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia; Vision CRC, USA
| | - Marc Labetoulle
- Ophthalmology Department, Hospital Bicêtre, APHP, Paris-Saclay University, Le Kremlin-Bicêtre, France; IDMIT (CEA-Paris Saclay-Inserm U1184), Fontenay-aux-Roses, France
| | - Stuti L Misra
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | | | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - John Sheppard
- Virginia Eye Consultants, Norfolk, VA, USA; Eastern Virginia Medical School, Norfolk, VA, USA
| | - Jelle Vehof
- Departments of Ophthalmology and Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Section of Ophthalmology, School of Life Course Sciences, King's College London, London, UK; Department of Ophthalmology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Piera Versura
- Cornea and Ocular Surface Analysis - Translation Research Laboratory, Ophthalmology Unit, DIMEC Alma Mater Studiorum Università di Bologna, Italy; IRCCS AOU di Bologna Policlinico di Sant'Orsola, Bologna, Italy
| | - Mark D P Willcox
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
| | - Jillian Ziemanski
- School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
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Li J, Matthews TA, Clausen T, Rugulies R. Workplace Discrimination and Risk of Hypertension: Findings From a Prospective Cohort Study in the United States. J Am Heart Assoc 2023; 12:e027374. [PMID: 37099326 PMCID: PMC10227217 DOI: 10.1161/jaha.122.027374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/17/2023] [Indexed: 04/27/2023]
Abstract
Background Mounting evidence has demonstrated a role of psychosocial stressors such as discrimination in hypertension and cardiovascular diseases. The objective of this study was to provide the first instance of research evidence examining prospective associations of workplace discrimination with onset of hypertension. Methods and Results Data were from MIDUS (Midlife in the United States), a prospective cohort study of adults in the United States. Baseline data were collected in 2004 to 2006, with an average 8-year follow-up period. Workers with self-reported hypertension at baseline were excluded, yielding a sample size of 1246 participants for the main analysis. Workplace discrimination was assessed using a validated 6-item instrument. During follow-up with 9923.17 person-years, 319 workers reported onset of hypertension, and incidence rates of hypertension were 25.90, 30.84, and 39.33 per 1000 person-years among participants with low, intermediate, and high levels of workplace discrimination, respectively. Cox proportional hazards regression analyses demonstrated that workers who experienced high exposure to workplace discrimination, compared with workers with low exposure, had a higher hazard of hypertension (adjusted hazard ratio, 1.54 [95% CI, 1.11-2.13]). Sensitivity analysis excluding more baseline hypertension cases based on additional information on blood pressure plus antihypertensive medication use (N=975) showed slightly stronger associations. A trend analysis showed an exposure-response association. Conclusions Workplace discrimination was prospectively associated with elevated risk of hypertension among US workers. The adverse impacts of discrimination on cardiovascular disease have major implications for workers' health and indicate a need for government and employer policy interventions addressing discrimination.
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Affiliation(s)
- Jian Li
- Department of Environmental Health Sciences, Fielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
- School of NursingUniversity of CaliforniaLos AngelesCAUSA
| | - Timothy A. Matthews
- Department of Environmental Health Sciences, Fielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
| | - Thomas Clausen
- National Research Centre for the Working EnvironmentCopenhagenDenmark
| | - Reiner Rugulies
- National Research Centre for the Working EnvironmentCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenDenmark
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Chen D, Sandler DP, Keil AP, Heiss G, Whitsel EA, Edwards JK, Stewart PA, Stenzel MR, Groth CP, Ramachandran G, Banerjee S, Huynh TB, Jackson WB, Blair A, Lawrence KG, Kwok RK, Engel LS. Volatile Hydrocarbon Exposures and Incident Coronary Heart Disease Events: Up to Ten Years of Follow-up among Deepwater Horizon Oil Spill Workers. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:57006. [PMID: 37224072 PMCID: PMC10208425 DOI: 10.1289/ehp11859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 04/09/2023] [Accepted: 04/28/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, response and cleanup workers were potentially exposed to toxic volatile components of crude oil. However, to our knowledge, no study has examined exposure to individual oil spill-related chemicals in relation to cardiovascular outcomes among oil spill workers. OBJECTIVES Our aim was to investigate the association of several spill-related chemicals [benzene, toluene, ethylbenzene, xylene, n-hexane (BTEX-H)] and total hydrocarbons (THC) with incident coronary heart disease (CHD) events among workers enrolled in a prospective cohort. METHODS Cumulative exposures to THC and BTEX-H across the cleanup period were estimated via a job-exposure matrix that linked air measurement data with self-reported DWH spill work histories. We ascertained CHD events following each worker's last day of cleanup work as the first self-reported physician-diagnosed myocardial infarction (MI) or a fatal CHD event. We estimated hazard ratios (HR) and 95% confidence intervals for the associations of exposure quintiles (Q) with risk of CHD. We applied inverse probability weights to account for bias due to confounding and loss to follow-up. We used quantile g-computation to assess the joint effect of the BTEX-H mixture. RESULTS Among 22,655 workers with no previous MI diagnoses, 509 experienced an incident CHD event through December 2019. Workers in higher quintiles of each exposure agent had increased CHD risks in comparison with the referent group (Q1) of that agent, with the strongest associations observed in Q5 (range of HR = 1.14 - 1.44 ). However, most associations were nonsignificant, and there was no evidence of exposure-response trends. We observed stronger associations among ever smokers, workers with ≤ high school education, and workers with body mass index < 30 kg / m 2 . No apparent positive association was observed for the BTEX-H mixture. CONCLUSIONS Higher exposures to volatile components of crude oil were associated with modest increases in risk of CHD among oil spill workers, although we did not observe exposure-response trends. https://doi.org/10.1289/EHP11859.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessie K. Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Mark R. Stenzel
- Exposure Assessment Applications, LLC, Arlington, Virginia, USA
| | - Caroline P. Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California – Los Angeles, Los Angeles, California, USA
| | - Tran B. Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - W. Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, North Carolina, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Kaitlyn G. Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Richard K. Kwok
- Population Studies and Genetics Branch, National Institute on Aging, Bethesda, Maryland, USA
| | - Lawrence S. Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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11
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Cook S, Hirschtick JL, Barnes G, Arenberg D, Bondarenko I, Patel A, Jiminez Mendoza E, Jeon J, Levy D, Meza R, Fleischer NL. Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study. BMJ Open 2023; 13:e062297. [PMID: 37085311 PMCID: PMC10124226 DOI: 10.1136/bmjopen-2022-062297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/06/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE Electronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study was to examine the prospective association between cigarette and ENDS use on self-reported incident hypertension. DESIGN Longitudinal cohort study. SETTING Nationally representative sample of the civilian, non-institutionalised population in the USA. PARTICIPANTS 17 539 adults aged 18 or older who participated at follow-up and had no self-reported heart condition or previous diagnosis of hypertension or high cholesterol at baseline. MEASURES We constructed a time-varying tobacco exposure, lagged by one wave, defined as no use, exclusive established use (every day or some days) of ENDS or cigarettes, and dual use. We controlled for demographics (age, sex, race/ethnicity and household income), clinical risk factors (family history of heart attack, obesity, diabetes and binge drinking) and smoking history (cigarette pack-years). OUTCOMES Self-reported incident hypertension diagnosis. RESULTS The self-reported incidence of hypertension was 3.7% between wave 2 and wave 5. At baseline, 18.0% (n=5570) of respondents exclusively smoked cigarettes; 1.1% (n=336) exclusively used ENDS; and 1.7% (n=570) were dual users. In adjusted models, exclusive cigarette use was associated with an increased risk of self-reported incident hypertension compared with non-use (adjusted HR (aHR) 1.21, 95% CI 1.06 to 1.38), while exclusive ENDS use (aHR 1.00, 95% CI 0.68 to 1.47) and dual use (aHR 1.15, 95% CI 0.87 to 1.52) were not. CONCLUSIONS We found that smoking increased the risk of self-reported hypertension, but ENDS use did not. These results highlight the importance of using prospective longitudinal data to examine the health effects of ENDS use.
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Affiliation(s)
- Steven Cook
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jana L Hirschtick
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Geoffrey Barnes
- Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan, USA
- Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas Arenberg
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Irina Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Akash Patel
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David Levy
- Georgetown University, Washington, DC, USA
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
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12
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Schaare HL, Blöchl M, Kumral D, Uhlig M, Lemcke L, Valk SL, Villringer A. Associations between mental health, blood pressure and the development of hypertension. Nat Commun 2023; 14:1953. [PMID: 37029103 PMCID: PMC10082210 DOI: 10.1038/s41467-023-37579-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/18/2023] [Indexed: 04/09/2023] Open
Abstract
Multiple studies have reported a link between mental health and high blood pressure with mixed or even contradictory findings. Here, we resolve those contradictions and further dissect the cross-sectional and longitudinal relationship between mental health, systolic blood pressure, and hypertension using extensive psychological, medical and neuroimaging data from the UK Biobank. We show that higher systolic blood pressure is associated with fewer depressive symptoms, greater well-being, and lower emotion-related brain activity. Interestingly, impending hypertension is associated with poorer mental health years before HTN is diagnosed. In addition, a stronger baseline association between systolic blood pressure and better mental health was observed in individuals who develop hypertension until follow-up. Overall, our findings offer insights on the complex relationship between mental health, blood pressure, and hypertension, suggesting that-via baroreceptor mechanisms and reinforcement learning-the association of higher blood pressure with better mental health may ultimately contribute to the development of hypertension.
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Affiliation(s)
- H Lina Schaare
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Otto-Hahn-Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Maria Blöchl
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute for Psychology, Leipzig University, Leipzig, Germany
| | - Deniz Kumral
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany
- Institute of Psychology, Clinical Psychology and Psychotherapy Unit, University of Freiburg, Freiburg, Germany
| | - Marie Uhlig
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lorenz Lemcke
- Nuclear Magnetic Resonance Unit, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sofie L Valk
- Otto-Hahn-Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- MindBrainBody Institute, Berlin School of Mind and Brain, Berlin, Germany
- Clinic of Cognitive Neurology, Leipzig University, Leipzig, Germany
- Charité University Medicine Berlin, Berlin, Germany
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13
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Pelgrims I, Devleesschauwer B, Vandevijvere S, De Clercq EM, Vansteelandt S, Gorasso V, Van der Heyden J. Using random-forest multiple imputation to address bias of self-reported anthropometric measures, hypertension and hypercholesterolemia in the Belgian health interview survey. BMC Med Res Methodol 2023; 23:69. [PMID: 36966305 PMCID: PMC10040120 DOI: 10.1186/s12874-023-01892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 03/16/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND In many countries, the prevalence of non-communicable diseases risk factors is commonly assessed through self-reported information from health interview surveys. It has been shown, however, that self-reported instead of objective data lead to an underestimation of the prevalence of obesity, hypertension and hypercholesterolemia. This study aimed to assess the agreement between self-reported and measured height, weight, hypertension and hypercholesterolemia and to identify an adequate approach for valid measurement error correction. METHODS Nine thousand four hundred thirty-nine participants of the 2018 Belgian health interview survey (BHIS) older than 18 years, of which 1184 participated in the 2018 Belgian health examination survey (BELHES), were included in the analysis. Regression calibration was compared with multiple imputation by chained equations based on parametric and non-parametric techniques. RESULTS This study confirmed the underestimation of risk factor prevalence based on self-reported data. With both regression calibration and multiple imputation, adjusted estimation of these variables in the BHIS allowed to generate national prevalence estimates that were closer to their BELHES clinical counterparts. For overweight, obesity and hypertension, all methods provided smaller standard errors than those obtained with clinical data. However, for hypercholesterolemia, for which the regression model's accuracy was poor, multiple imputation was the only approach which provided smaller standard errors than those based on clinical data. CONCLUSIONS The random-forest multiple imputation proves to be the method of choice to correct the bias related to self-reported data in the BHIS. This method is particularly useful to enable improved secondary analysis of self-reported data by using information included in the BELHES. Whenever feasible, combined information from HIS and objective measurements should be used in risk factor monitoring.
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Affiliation(s)
- Ingrid Pelgrims
- Service Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
- Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium.
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium.
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Salisburylaan 133, Hoogbouw, B-9820, Merelbeke, Belgium
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Eva M De Clercq
- Service Risk and Health Impact Assessment, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
| | - Stijn Vansteelandt
- Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, BE-9000, Ghent, Belgium
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Rue Juliette Wytsman 14, 1050, Brussels, Belgium
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14
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Chen D, Sandler DP, Keil AP, Heiss G, Whitsel EA, Pratt GC, Stewart PA, Stenzel MR, Groth CP, Banerjee S, Huynh TB, Edwards JK, Jackson WB, Engeda J, Kwok RK, Werder EJ, Lawrence KG, Engel LS. Fine particulate matter and incident coronary heart disease events up to 10 years of follow-up among Deepwater Horizon oil spill workers. ENVIRONMENTAL RESEARCH 2023; 217:114841. [PMID: 36403648 PMCID: PMC9825646 DOI: 10.1016/j.envres.2022.114841] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/05/2022] [Accepted: 11/15/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND During the 2010 Deepwater Horizon (DWH) disaster, in-situ burning and flaring were conducted to remove oil from the water. Workers near combustion sites were potentially exposed to burning-related fine particulate matter (PM2.5). Exposure to PM2.5 has been linked to increased risk of coronary heart disease (CHD), but no study has examined the relationship among oil spill workers. OBJECTIVES To investigate the association between estimated PM2.5 from burning/flaring of oil/gas and CHD risk among the DWH oil spill workers. METHODS We included workers who participated in response and cleanup activities on the water during the DWH disaster (N = 9091). PM2.5 exposures were estimated using a job-exposure matrix that linked modelled PM2.5 concentrations to detailed DWH spill work histories provided by participants. We ascertained CHD events as the first self-reported physician-diagnosed CHD or a fatal CHD event that occurred after each worker's last day of burning exposure. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for the associations between categories of average or cumulative daily maximum PM2.5 exposure (versus a referent category of water workers not near controlled burning) and subsequent CHD. We assessed exposure-response trends by examining continuous exposure parameters in models. RESULTS We observed increased CHD hazard among workers with higher levels of average daily maximum exposure (low vs. referent: HR = 1.26, 95% CI: 0.93, 1.70; high vs. referent: HR = 2.11, 95% CI: 1.08, 4.12; per 10 μg/m3 increase: HR = 1.10, 95% CI: 1.02, 1.19). We also observed suggestively elevated HRs among workers with higher cumulative daily maximum exposure (low vs. referent: HR = 1.19, 95% CI: 0.68, 2.08; medium vs. referent: HR = 1.38, 95% CI: 0.88, 2.16; high vs. referent: HR = 1.44, 95% CI: 0.96, 2.14; per 100 μg/m3-d increase: HR = 1.03, 95% CI: 1.00, 1.05). CONCLUSIONS Among oil spill workers, exposure to PM2.5 from flaring/burning of oil/gas was associated with increased risk of CHD.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Alexander P Keil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gregory C Pratt
- Division of Environmental Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Mark R Stenzel
- Exposure Assessment Applications, LLC, Arlington, VA, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Sudipto Banerjee
- Department of Biostatistics, Fielding School of Public Health, University of California - Los Angeles, Los Angeles, CA, USA
| | - Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Joseph Engeda
- Social & Scientific Systems, Inc, a DLH Holdings Company, Durham, NC, USA
| | - Richard K Kwok
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA; Office of the Director, National Institute of Environmental Health Sciences, Bethesda, MD, USA
| | - Emily J Werder
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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15
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Piri N, Moradi Y, Gheshlagh RG, Abdullahi M, Fattahi E, Moradpour F. Validity of self-reported hypertension and related factors in the adult population: Preliminary results from the cohort in the west of Iran. J Clin Hypertens (Greenwich) 2023; 25:146-157. [PMID: 36625724 PMCID: PMC9903199 DOI: 10.1111/jch.14627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
This study aimed to investigate the validity of self-reported hypertension and related factors in the Dehgolan Prospective Cohort Study (DehPCS). Data were obtained from 3996 participants aged 35-70 years in the enrolment phase of DehPCS. Self-reported hypertension and sociodemographic factors were collected by well-trained interviewers before hypertension diagnosis based on the reference criteria. The history of anti-hypertensive medication use and/or systolic blood pressure ≥140 (mmHg), or diastolic blood pressure ≥90 (mmHg) were considered as hypertension. Disagreement between self-reported and reference measures was assessed using sensitivity, specificity, positive, and negative predictive values (PPV and NPV), and kappa values. Binary and multinomial logistic regressions were used to investigate the correlates of validity of self-reported hypertension. The hypertension prevalence based on self-reports and the reference criteria was 19.49% and 21.60%, respectively. An acceptable percentage of kappa agreement value of 68.7% and relatively good overall agreement of 89.8% were found. Self-reported hypertension was guaranteed moderate sensitivity of 72.0% and high specificity of 94.5%, as well as the NPV and PPV of 92/7% and 77/9%, respectively. The chances of false-positive and false-negative reporting increased with older age, higher BMI, and a family history of hypertension. Being female, older age, higher BMI, concurrent diabetes, and stronger family ties to hypertension patients significantly increased the chance of reporting true positives relative to true negatives. Although, self-reported hypertension has an acceptable validity and can be used as a valid tool for screening epidemiological studies, it needs to be investigated because its validity is affected by age, gender, family history of hypertension, and other socio-demographic characteristics.
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Affiliation(s)
- Negar Piri
- Health Network of DehgolanKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Department of Epidemiology and BiostatisticsFaculty of MedicineKurdistan University of Medical SciencesSanandajIran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | | | - Eghbal Fattahi
- Department of Internal MedicineTohid HospitalKurdistan University of Medical SciencesSanandajIran
| | - Farhad Moradpour
- Social Determinants of Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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16
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Sharma Y, Bhargava A, Doan D, Caceres BA. Examination of Sexual Identity Differences in the Prevalence of Hypertension and Antihypertensive Medication Use Among US Adults: Findings From the Behavioral Risk Factor Surveillance System. Circ Cardiovasc Qual Outcomes 2022; 15:e008999. [PMID: 36538586 PMCID: PMC9782752 DOI: 10.1161/circoutcomes.122.008999] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recent evidence suggests that sexual minority (eg, gay/lesbian, bisexual) adults might be at increased risk of hypertension compared with heterosexual adults. However, disparities by sexual identity in antihypertensive medication use among adults with hypertension have not been comprehensively examined. METHODS We analyzed data from the Behavioral Risk Factor Surveillance System (2015-2019), to examine sexual identity differences in the prevalence of hypertension and antihypertensive medication use among adults. We ran sex-stratified logistic regression models to estimate the odds ratios of diagnosis of hypertension and antihypertensive medication use among sexual minority (ie, gay/lesbian, bisexual, and other) and heterosexual adults (reference group). RESULTS The sample included 420 340 participants with a mean age of 49.7 (±17.0) years, of which 66.7% were Non-Hispanic White. Compared with heterosexual participants of the same sex, bisexual women (adjusted odds ratio, 1.19 [95% CI, 1.03-1.37]) and gay men (adjusted odds ratio, 1.18 [95% CI, 1.03-1.35]) were more likely to report having been diagnosed with hypertension. Among women with diagnosed hypertension, bisexual women had lower odds of current antihypertensive medication use (adjusted odds ratio, 0.71 [95% CI, 0.56-0.90]). Among men with diagnosed hypertension, gay men were more likely than heterosexual men to report current antihypertensive medication use (adjusted odds ratio, 1.39 [95% CI, 1.10-1.78]). Compared with heterosexual participants of the same sex, there were no differences in hypertension or antihypertensive medication use among lesbian women, bisexual men, and participants who reported their sexual identity as other. CONCLUSIONS Clinical and public health interventions are needed to reduce the risk of hypertension among bisexual women and gay men. Bisexual women were at higher risk of untreated hypertension, which may be attributed to lower health care utilization due to fear of discrimination from health care providers and socioeconomic disadvantage. Future research is needed to better understand factors that may contribute to untreated hypertension among bisexual women with hypertension.
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Affiliation(s)
- Yashika Sharma
- Candidate Center for Sexual and Gender Minority Health Research (Y.S., B.A.C.), Columbia University School of Nursing, NY
| | - Anisha Bhargava
- Research Assistant Center for Sexual and Gender Minority Health Research (A.B.), Columbia University School of Nursing, NY
| | - Danny Doan
- Research Assistant Center for Sexual and Gender Minority Health Research (D.D.), Columbia University School of Nursing, NY
| | - Billy A Caceres
- Candidate Center for Sexual and Gender Minority Health Research (Y.S., B.A.C.), Columbia University School of Nursing, NY
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Ntenda PAM, El-Meidany WMR, Tiruneh FN, Motsa MPS, Nyirongo J, Chirwa GC, Kapachika A, Nkoka O. Determinants of self-reported hypertension among women in South Africa: evidence from the population-based survey. Clin Hypertens 2022; 28:39. [PMCID: PMC9664601 DOI: 10.1186/s40885-022-00222-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Hypertension (HTN), characterized by an elevation of blood pressure, is a serious public health chronic condition that significantly raises the risks of heart, brain, kidney, and other diseases. In South Africa, the prevalence of HTN (measured objectively) was reported at 46.0% in females, nonetheless little is known regarding the prevalence and risks factors of self-reported HTN among the same population. Therefore, the aim of this study was to examine determinants of self-reported HTN among women in South Africa.
Methods
The study used data obtained from the 2016 South African Demographic and Health Survey. In total, 6,027 women aged ≥ 20 years were analyzed in this study. Self-reported HTN was defined as a case in which an individual has not been clinically diagnosed with this chronic condition by a medical doctor, nurse, or health worker. Multiple logistic regression models were employed to examine the independent factors of self-reported HTN while considering the complex survey design.
Results
Overall, self-reported HTN was reported in 23.6% (95% confidence interval [CI], 23.1–24.1) of South African women. Being younger (adjusted odds ratio [aOR], 0.04; 95% CI, 0.03–0.06), never married (aOR, 0.69; 95% CI, 0.56–0.85), and not covered by health insurance (aOR, 0.74; 95% CI, 0.58–0.95) reduced the odds of self-reported HTN. On the other hand, being black/African (aOR, 1.73; 95% CI, 1.17–2.54), perception of being overweight (aOR, 1.72; 95% CI, 1.40–2.11), and perception of having poor health status (aOR, 3.53; 95% CI, 2.53–5.21) and the presence of other comorbidities (aOR, 7.92; 95% CI, 3.63–17.29) increased the odds of self-reported HTN.
Conclusions
Self-reported HTN was largely associated with multiple sociodemographic, health, and lifestyle factors and the presence of other chronic conditions. Health promotion and services aiming at reducing the burden of HTN in South Africa should consider the associated factors reported in this study to ensure healthy aging and quality of life among women.
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Singh SK, Sharma SK, Mohanty SK, Mishra R, Porwal A, Kishan Gulati B. Inconsistency in prevalence of hypertension based on self-reports and use of standard tests: Implications for large scale surveys. SSM Popul Health 2022; 19:101255. [PMID: 36217312 PMCID: PMC9547289 DOI: 10.1016/j.ssmph.2022.101255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/30/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Biomarkers are increasingly integrated into population-based surveys to provide reliable estimates of the prevalence of specific diseases. The Demographic and Health Surveys have recently incorporated blood pressure measurements; however, little is known about the extent of agreement between measured and reported levels of hypertension in India. The objective of this study was to examine the extent of agreement between self-reported hypertension and the results of standard blood pressure measurements, as well as to explore the risk groups and factors associated with inconsistencies in self-reported and biomedically measured hypertension. Methods Reliability measures such as sensitivity, specificity, and kappa statistics were used to examine inconsistencies in self-reported and biomedically measured hypertension in the National Family Health Survey-4 data. Multilevel logistic models were adopted to analyse the respondent characteristics related to both false-positive and false-negative responses in the survey. Results Compared to biomedically measured hypertension, self-reported hypertension was inconsistent and disproportionate at disaggregated levels in India. While self-reports severely underestimated hypertension among men aged 15-54 years and women aged 35-49 years, it overestimated hypertension among women below the age of 35 years. The inconsistency in self-reported and biomedically examined hypertension had deviations from a sex standpoint. Women aged <35 years reported a false-positive prevalence of hypertension. False-negative responses were elucidated among women aged ≥35 years and men aged 15-54 years. The likelihood of false-positive responses was higher among pregnant and obese respondents, and those who consumed alcohol. Conclusion The significant deviance of self-reporting of hypertension from the prevalence derived based on standard tests further indicates the need for adopting standard tests in all emerging future large-scale surveys. A back-check survey is recommended to understand and differentiate the excessive false-positive reporting of hypertension among women aged 15-35 years.
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Affiliation(s)
- Shri Kant Singh
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Santosh Kumar Sharma
- International Institute for Population Sciences, Mumbai, India,Corresponding author.
| | - Sanjay K. Mohanty
- Department of Population & Development, International Institute for Population Sciences, Mumbai, India
| | | | | | - Bal Kishan Gulati
- National Institute of Medical Statistics, Indian Council of Medical Research, India
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Adulthood Psychosocial Disadvantages and Risk of Hypertension in U.S. Workers: Effect Modification by Adverse Childhood Experiences. Life (Basel) 2022; 12:life12101507. [PMID: 36294941 PMCID: PMC9604677 DOI: 10.3390/life12101507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/22/2022] [Accepted: 09/24/2022] [Indexed: 11/16/2022] Open
Abstract
Hypertension is a key driver of cardiovascular diseases. However, how stressors contribute to the development of hypertension remains unclear. The objective of this study was to examine prospective associations of adverse childhood experiences (ACEs) and adulthood psychosocial disadvantages (APDs) with incident hypertension. Data were from the Mid-life in the United States (MIDUS) study, a national, population-based, prospective cohort study. ACEs were examined via retrospective reports, and APDs including work stress and social isolation were assessed using survey measures. Incident hypertension was defined based on self-reported physician diagnosis. Baseline data were collected in 1995, with follow-up in 2004-2006 and 2013-2014. Cox proportional hazards regression was applied to assess prospective associations of ACEs and APDs with incident hypertension in 2568 workers free from hypertension at baseline. After adjustment for covariates, baseline APDs were associated with increased incident hypertension (aHR and 95% CI = 1.48 [1.09, 2.01]) during a 20-year follow-up, whereas ACEs showed null associations. Moreover, a moderating effect by ACEs was observed-the effect of APDs on risk of hypertension was stronger when ACEs were present (aHR and 95% CI = 1.83 [1.17, 2.86]). These findings underscore the importance of psychosocial stressors as nontraditional risk factors of cardiometabolic disorders.
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Liu X, Matthews TA, Chen L, Li J. The associations of job strain and leisure-time physical activity with the risk of hypertension: the population-based Midlife in the United States cohort study. Epidemiol Health 2022; 44:e2022073. [PMID: 36108671 PMCID: PMC9849846 DOI: 10.4178/epih.e2022073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/07/2022] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Job strain is positively associated with incident hypertension, while increasing leisure-time physical activity (LTPA) can reduce incident hypertension. However, the joint associations of job strain and LTPA with incident hypertension among United States workers have yet to be investigated. This study examined the independent and joint associations of job strain and LTPA with incident hypertension. METHODS This prospective cohort study (n=1,160) utilized data from the population-based Midlife in the United States study. The associations of job strain and LTPA at baseline with incident hypertension during follow-up were examined using Cox proportional hazards models. High job strain was derived from a combination of high job demands and low job control, and high LTPA was defined as engagement in moderate or vigorous LTPA at least once per week. RESULTS During 9,218 person-years of follow-up, the hypertension incidence rate was 30.6 (95% confidence interval [CI], 27.3 to 34.3) per 1,000 person-years. High job strain was associated with a higher risk for hypertension than low job strain (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.00 to 1.67). High LTPA was associated with lower hypertension risk than low LTPA (aHR, 0.77; 95% CI, 0.60 to 0.98). Hypertension risk was higher among workers with high job strain and low LTPA than among those with low job strain and high LTPA (aHR, 1.70; 95% CI, 1.18 to 2.43). CONCLUSIONS Job strain and LTPA showed positive and inverse associations, respectively, with incident hypertension. The combination of high job strain and low LTPA was associated with the highest risk for hypertension.
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Affiliation(s)
- Xinyue Liu
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Timothy A. Matthews
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA,School of Nursing, University of California Los Angeles, Los Angeles, CA, USA,Correspondence: Jian Li Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA E-mail:
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21
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Steinkirchner AB, Zimmermann ME, Donhauser FJ, Dietl A, Brandl C, Koller M, Loss J, Heid IM, Stark KJ. Self-report of chronic diseases in old-aged individuals: extent of agreement with general practitioner medical records in the German AugUR study. J Epidemiol Community Health 2022; 76:jech-2022-219096. [PMID: 36028306 PMCID: PMC9554083 DOI: 10.1136/jech-2022-219096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND To estimate prevalence and incidence of diseases through self-reports in observational studies, it is important to understand the accuracy of participant reports. We aimed to quantify the agreement of self-reported and general practitioner-reported diseases in an old-aged population and to identify socio-demographic determinants of agreement. METHODS This analysis was conducted as part of the AugUR study (n=2449), a prospective population-based cohort study in individuals aged 70-95 years, including 2321 participants with consent to contact physicians. Self-reported chronic diseases of participants were compared with medical data provided by their respective general practitioners (n=589, response rate=25.4%). We derived overall agreement, over-reporting/under-reporting, and Cohen's kappa and used logistic regression to evaluate the dependency of agreement on participants' sociodemographic characteristics. RESULTS Among the 589 participants (53.1% women), 96.9% reported at least one of the evaluated chronic diseases. Overall agreement was >80% for hypertension, diabetes, myocardial infarction, stroke, cancer, asthma, bronchitis/chronic obstructive pulmonary disease and rheumatoid arthritis, but lower for heart failure, kidney disease and arthrosis. Cohen's kappa was highest for diabetes and cancer and lowest for heart failure, musculoskeletal, kidney and lung diseases. Sex was the primary determinant of agreement on stroke, kidney disease, cancer and rheumatoid arthritis. Agreement for myocardial infarction and stroke was most compromised by older age and for cancer by lower educational level. CONCLUSION Self-reports may be an effective tool to assess diabetes and cancer in observational studies in the old and very old aged. In contrast, self-reports on heart failure, musculoskeletal, kidney or lung diseases may be substantially imprecise.
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Affiliation(s)
- Anna B Steinkirchner
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Martina E Zimmermann
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | | | - Alexander Dietl
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Caroline Brandl
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
- Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Julika Loss
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Iris M Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Klaus J Stark
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
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22
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Muhammad T, Paul R, Rashmi R, Srivastava S. Examining sex disparity in the association of waist circumference, waist-hip ratio and BMI with hypertension among older adults in India. Sci Rep 2022; 12:13117. [PMID: 35907951 PMCID: PMC9338983 DOI: 10.1038/s41598-022-17518-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 07/26/2022] [Indexed: 11/12/2022] Open
Abstract
Hypertension is a public health issue touted as a “silent killer” worldwide. The present study aimed to explore the sex differential in the association of anthropometric measures including body mass index, waist circumference, and waist-hip ratio with hypertension among older adults in India. The study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017–18. The sample contains 15,098 males and 16,366 females aged 60 years and above. Descriptive statistics (percentages) along with bivariate analysis were presented. Multivariable binary logistic regression analyses were used to examine the associations between the outcome variable (hypertension) and putative risk or protective factors. About 33.9% of males and 38.2% of females aged 60 years and above suffered from hypertension. After adjusting for the socioeconomic, demographic and health-behavioral factors, the odds of hypertension were 1.37 times (CI: 1.27–1.47), significantly higher among older adults who were obese or overweight than those with no overweight/obese condition. Older adults with high-risk waist circumference and waist-hip ratio had 1.16 times (CI: 1.08–1.25) and 1.42 times (CI: 1.32–1.51) higher odds of suffering from hypertension, respectively compared to their counterparts with no high-risk waist circumference or waist-hip ratio. The interaction effects showed that older females with overweight/obesity [OR: 0.84; CI: 0.61–0.74], high-risk waist circumference [OR: 0.89; CI: 0.78–0.99], and high-risk waist-hip ratio [OR: 0.90; CI: 0.83–0.97] had a lower chance of suffering from hypertension than their male counterparts with the similar anthropometric status. The findings suggested a larger magnitude of the association between obesity, high-risk waist circumference, high-risk waist-hip ratio and prevalent hypertension among older males than females. The study also highlights the importance of measuring obesity and central adiposity in older individuals and using such measures as screening tools for timely identification of hypertension.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Rashmi Rashmi
- International Institute for Population Sciences, Mumbai, 400088, India
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Hypertension and cognition are minimally associated in late life. Hypertens Res 2022; 45:1622-1631. [PMID: 35787658 DOI: 10.1038/s41440-022-00970-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/07/2022] [Accepted: 05/18/2022] [Indexed: 01/13/2023]
Abstract
Hypertension impacts approximately 65% of persons over 60 years of age. Although previous studies have proposed an association between mid-life hypertension and late-life cognition, reports of associations between late-life hypertension and cognition have been mixed in the direction and magnitude of the observed associations and in the cognitive domains that may be affected. This study contrasted older adults with and without self-reported hypertension at two time points in late life (MBaseline age = 64.3 years, SD1 = 0.7; MFollow-up age = 71.2 years, SD2 = 0.9), separated by approximately seven years. Participants included 4314 1957 high school graduates from the Wisconsin Longitudinal Study who were followed longitudinally until 2011. Cognitive, demographic, and health variables from the 2003-2005 and 2011 data collection waves were used. Cognitive measures included letter and category fluency, digit ordering, similarities, and immediate and delayed recall. Bayesian independent t tests and regressions examined the association between self-reported hypertension status and cognition at baseline and follow-up. Persons with self-reported hypertension over seven years showed slightly worse letter fluency and digit ordering performance at follow-up than persons without self-reported hypertension. No baseline cognitive differences were observed between groups. Participants with self-reported hypertension showed no improvement in letter fluency or digit ordering compared to persons without self-reported hypertension. After controlling for cardiovascular risk factors, hypertension was associated only with a slight decline in letter fluency. Finally, hypertension duration was not associated with cognitive performance. Self-reported hypertension was associated with minimal to no effects on cognition in older adults. Controlling for cardiovascular risk factors eliminated virtually all associations between self-reported hypertension and cognition.
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Bacurau AGDM, Francisco PMSB. Doenças crônicas em idosos e vacinação contra a influenza. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)2819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: As informações sobre a presença de doenças crônicas nos idosos não são registradas durante as campanhas de vacinação contra influenza, o que dificulta sua identificação (proporção) nos idosos vacinados. Objetivo: Descrever a prevalência de doenças crônicas autorreferidas em idosos vacinados contra a influenza; verificar a influência da mídia na decisão de tomar a vacina; e se recebeu orientações sobre a importância dela, segundo o tipo de profissional de saúde. Métodos: Estudo transversal descritivo, com dados coletados por meio de entrevistas com idosos vacinados contra influenza (n=798) em um Centro de Saúde de Campinas (SP) em 2019. Resultados: Na amostra estudada, a maioria eram mulheres (58,0%), indivíduos com ensino médio completo ou ensino superior (53,0%) e com plano de saúde (72,3%). As doenças mais prevalentes foram hipertensão arterial (56,9%; intervalo de confiança — IC95% 53,4–60,3), diabetes (24,7%; IC95% 21,8–27,8), doenças cardíacas (13,6%; IC95% 11,4–16,2) e respiratórias (5,6%; IC95% 4,2–7,5). A maioria (58,0%) considerou que a mídia influenciou sua decisão de tomar a vacina. Receberam orientações sobre a importância da vacinação 21,1% dos idosos, fornecidas principalmente por médicos/as (67,4%), enfermeiros/as (18,2%) e agentes de saúde (7,0%). Conclusões: A investigação mostrou que as principais doenças referidas pelos idosos vacinados foram hipertensão arterial, diabetes, cardiopatias e doenças respiratórias. A orientação de profissionais da saúde foi pouco relatada pelos idosos e a maioria referiu influência da mídia na decisão de vacinar-se. Ressaltam-se a necessidade e a relevância de investir em estratégias de comunicação em saúde, a fim de esclarecer a população sobre a importância da vacinação contra a influenza para as pessoas idosas e com doenças crônicas.
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25
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Comparing self-reported and measured hypertension and hypercholesterolaemia at standard and more stringent diagnostic thresholds: the cross-sectional 2010-2015 Busselton Healthy Ageing study. Clin Hypertens 2022; 28:16. [PMID: 35642010 PMCID: PMC9158272 DOI: 10.1186/s40885-022-00199-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Population health behaviour and risk factor surveys most often rely on self-report but there is a lack of studies assessing the validity of self-report using Australian data. This study investigates the sensitivity, specificity and agreement of self-reported hypertension and hypercholesterolaemia with objective measures at standard and more stringent diagnostic thresholds; and factors associated with sensitivity and specificity of self-report at different thresholds. Methods This study was a secondary analysis of a representative community-based cross-sectional sample of 5,092 adults, aged 45–69 years, residing in Busselton, Western Australia, surveyed in 2010–2015. Participants completed a self-administered questionnaire. Blood pressure and serum cholesterol levels were measured. Results At currently accepted diagnostic thresholds, sensitivities of self-reported hypertension and hypercholesterolaemia were 58.5% and 39.6%, respectively and specificities were >90% for both. Agreement using Cohen’s kappa coefficient was 0.562 and 0.223, respectively. At two higher diagnostic thresholds, sensitivities of self-reported hypertension and hypercholesterolaemia improved by an absolute 14–23% and 15–25%, respectively and specificities remained >85%. Agreement was substantial for hypertension (kappa = 0.682–0.717) and moderate for hypercholesterolaemia (kappa = 0.458–0.533). Variables that were independently associated with higher sensitivity and lower specificity of self-report were largely consistent across thresholds and included increasing age, body mass index, worse self-rated health, diabetes and family history of hypertension. Conclusions Self-reported hypertension and hypercholesterolaemia often misclassify individuals’ objective status and underestimate objective prevalences, at standard diagnostic thresholds, which has implications for surveillance studies that rely on self-reported data. Self-reports of hypertension, however, may be reasonable indicators of those with blood pressures ≥160/100 mmHg or those taking anti-hypertensive medications. Self-reported hypercholesterolaemia data should be used with caution at all thresholds.
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Caceres BA, Sharma Y, Doan D. Hypertension risk in sexual and gender minority individuals. Expert Rev Cardiovasc Ther 2022; 20:339-341. [PMID: 35532894 PMCID: PMC9233064 DOI: 10.1080/14779072.2022.2075345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Billy A Caceres
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
| | - Yashika Sharma
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
| | - Danny Doan
- Center for Sexual and Gender Minority Health Research, Columbia University School of Nursing, New York, NY, USA
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27
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Chan II, Kwok MK, Schooling CM. Timing of Pubertal Development and Midlife Blood Pressure in Men and Women: A Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e386-e393. [PMID: 34343299 DOI: 10.1210/clinem/dgab561] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Observational studies suggest earlier puberty is associated with higher adulthood blood pressure (BP), but these findings have not been replicated using Mendelian randomization (MR). We examined this question sex-specifically using larger genome-wide association studies (GWAS) with more extensive measures of pubertal timing. METHODS We obtained genetic instruments proxying pubertal maturation (age at menarche [AAM] or voice breaking [AVB]) from the largest published GWAS. We applied them to summary sex-specific genetic associations with systolic and diastolic BP z-scores, and self-reported hypertension in women (n = 194 174) and men (n = 167 020) from the UK Biobank, using inverse-variance weighted meta-analysis. We conducted sensitivity analyses using other MR methods, including multivariable MR adjusted for childhood obesity proxied by body mass index (BMI). We used late pubertal growth as a validation outcome. RESULTS AAM (beta per 1-year later = -0.030 [95% confidence interval, -0.055 to -0.005] and AVB (beta -0.058 [95% CI, -0.100 to -0.015]) were inversely associated with systolic BP independent of childhood BMI, as were diastolic BP (-0.035 [95% CI, -0.060 to -0.009] for AAM and -0.046 [95% CI, -0.089 to -0.004] for AVB) and self-reported hypertension (odds ratio 0.89 [95% CI, 0.84-0.95] for AAM and 0.87 [95% CI, 0.79-0.96] for AVB). AAM and AVB were positively associated with late pubertal growth, as expected. The results were robust to sensitivity analysis using other MR methods. CONCLUSION Timing of pubertal maturation was associated with adulthood BP independent of childhood BMI, highlighting the role of pubertal maturation timing in midlife BP.
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Affiliation(s)
- Io Ieong Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Ki Kwok
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Graduate School of Public Health and Health Policy, City University of New York, NY 10027, USA
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Gaziano L, Cho K, Djousse L, Schubert P, Galloway A, Ho Y, Kurgansky K, Gagnon DR, Russo JP, Di Angelantonio E, Wood AM, Danesh J, Gaziano JM, Butterworth AS, Wilson PW, Joseph J. Risk factors and prediction models for incident heart failure with reduced and preserved ejection fraction. ESC Heart Fail 2021; 8:4893-4903. [PMID: 34528757 PMCID: PMC8712836 DOI: 10.1002/ehf2.13429] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 01/09/2023] Open
Abstract
AIMS This study aims to develop the first race-specific and sex-specific risk prediction models for heart failure with preserved (HFpEF) and reduced ejection fraction (HFrEF). METHODS AND RESULTS We created a cohort of 1.8 million individuals who had an outpatient clinic visit between 2002 and 2007 within the Veterans Affairs (VA) Healthcare System and obtained information on HFpEF, HFrEF, and several risk factors from electronic health records (EHR). Variables were selected for the risk prediction models in a 'derivation cohort' that consisted of individuals with baseline date in 2002, 2003, or 2004 using a forward stepwise selection based on a change in C-index threshold. Discrimination and calibration were assessed in the remaining participants (internal 'validation cohort'). A total of 66 831 individuals developed HFpEF, and 92 233 developed HFrEF (52 679 and 71 463 in the derivation cohort) over a median of 11.1 years of follow-up. The HFpEF risk prediction model included age, diabetes, BMI, COPD, previous MI, antihypertensive treatment, SBP, smoking status, atrial fibrillation, and estimated glomerular filtration rate (eGFR), while the HFrEF model additionally included previous CAD. For the HFpEF model, C-indices were 0.74 (SE = 0.002) for white men, 0.76 (0.005) for black men, 0.79 (0.015) for white women, and 0.77 (0.026) for black women, compared with 0.72 (0.002), 0.72 (0.004), 0.77 (0.017), and 0.75 (0.028), respectively, for the HFrEF model. These risk prediction models were generally well calibrated in each race-specific and sex-specific stratum of the validation cohort. CONCLUSIONS Our race-specific and sex-specific risk prediction models, which used easily obtainable clinical variables, can be a useful tool to implement preventive strategies or subtype-specific prevention trials in the nine million users of the VA healthcare system and the general population after external validation.
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Affiliation(s)
- Liam Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Kelly Cho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- Department of Medicine, Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Luc Djousse
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- Department of Medicine, Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Petra Schubert
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
| | - Ashley Galloway
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
| | - Yuk‐Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
| | - Katherine Kurgansky
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
| | - David R. Gagnon
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- Department of BiostatisticsBoston University School of Public HealthBostonMAUSA
| | - John P. Russo
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- Landmark CollegePutneyVTUSA
| | - Emanuele Di Angelantonio
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Angela M. Wood
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - John Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - John Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- Department of Medicine, Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Adam S. Butterworth
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Peter W.F. Wilson
- Atlanta VA Medical CenterDecaturGAUSA
- Department of Medicine, Division of Cardiovascular DiseaseEmory University School of MedicineAtlantaGAUSA
| | - Jacob Joseph
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Cardiology SectionVA Boston Healthcare System1400 VFW Parkway, West RoxburyBostonMA02132USA
- Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
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Tolonen H, Reinikainen J, Koponen P, Elonheimo H, Palmieri L, Tijhuis MJ. Cross-national comparisons of health indicators require standardized definitions and common data sources. Arch Public Health 2021; 79:208. [PMID: 34819157 PMCID: PMC8614034 DOI: 10.1186/s13690-021-00734-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background Health indicators are used to monitor the health status and determinants of health of the population and population sub-groups, identify existing or emerging health problems which would require prevention and health promotion activities, help to target health care resources in the most adequate way as well as for evaluation of the success of public health actions both at the national and international level. The quality and validity of the health indicator depends both on available data and used indicator definition. In this study we will evaluate existing knowledge about comparability of different data sources for definition of health indicators, compare how selected health indicators presented in different international databases possibly differ, and finally, present the results from a case study from Finland on comparability of health indicators derived from different data sources at national level. Methods For comparisons, four health indicators were selected that were commonly available in international databases and available for the Finnish case study. These were prevalence of obesity, hypertension, diabetes, and asthma in the adult populations. Our evaluation has three parts: 1) a scoping review of the latest literature, 2) comparison of the prevalences presented in different international databases, and 3) a case study using data from Finland. Results Literature shows that comparability of estimated outcomes for health indicators using different data sources such as self-reported questionnaire data from surveys, measured data from surveys or data from administrative health registers, varies between indicators. Also, the case study from Finland showed that diseases which require regular health care visits such as diabetes, comparability is high while for health outcomes which can remain asymptomatic for a long time such as hypertension, comparability is lower. In different international health related databases, country specific results differ due to variations in the used data sources but also due to differences in indicator definitions. Conclusions Reliable comparison of the health indicators over time and between regions within a country or across the countries requires common indicator definitions, similar data sources and standardized data collection methods.
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Affiliation(s)
- Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Jaakko Reinikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Päivikki Koponen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Hanna Elonheimo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-metabolic Diseases and Ageing, Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Mariken J Tijhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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24-h-Ambulatory Blood Pressure Monitoring in Sub-Saharan Africa: Hypertension Phenotypes and Dipping Patterns in Malawian HIV+ Patients on Antiretroviral Therapy. Glob Heart 2021; 16:67. [PMID: 34692392 PMCID: PMC8516010 DOI: 10.5334/gh.945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 09/22/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Cardiovascular disease and especially hypertension are a growing problem among people living with HIV (PLHIV) on antiretroviral therapy (ART) in sub-Saharan Africa. Objectives: As robust data on hypertension phenotypes associated with distinct cardiovascular risks among PLHIV are limited, we aimed to assess the frequency of white-coat (WCH), masked (MH) hypertension, and blood pressure dipping-patterns in a group of Malawian PLHIV. Methods: As part of the prospective Lighthouse-Tenofovir-Cohort-Study, we analyzed clinical, laboratory and 24-h-ambulatory blood pressure monitoring (ABPM) data of PLHIV from urban Lilongwe with treated or untreated hypertension or raised office blood pressure (OBP) during routine study-visits. Results: 118 PLHIV were included and data of 117 participants could be analyzed. Twenty–four-hour ABPM normotension was found in a total of 73 PLHIV including 14/37 on antihypertensive treatment (37.8%). Using strict definitions, i.e. normal OBP plus normal mean BP for all periods of ABPM, controlled hypertension was found in only 4/37 (10.8%) PLHIV on antihypertensive treatment while true normotension was observed in 10/24 untreated patients (41.7%) with previously diagnosed hypertension and 22/56 patients (39.3%) without a medical history of hypertension. WCH with normal BP during all periods of 24-h-ABPM was identified in 12/64 OBP-hypertensive PLHIV (18.8%), primarily in patients with grade 1 hypertension (11/41 patients; 26.8%). MH was found in 17/53 PLHIV with OBP-normotension (32.1%), predominantly in patients with high normal BP (11/20 patients; 55%). The estimated glomerular filtration rate tended to be lower in MH compared to strictly defined normotensive PLHIV (92.0±20.4 vs. 104.8±15.7 ml/min/m²). 64.1 percent of PLHIV (59.5% with 24-h hypertension and 66.7% with 24-h normotension) had abnormal systolic dipping. Conclusion: The high prevalence of WCH and MH with signs of early renal end-organ damage and an abnormal dipping in approximately 2/3 of PLHIV warrants further investigation as these factors may contribute to the increased cardiovascular risk in PLHIV in resource-limited settings like Malawi. Clinical Trial Registration: https://clinicaltrials.gov (NCT02381275), registered March 6th, 2015.
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Self-reported periodontal health and incident hypertension: longitudinal evidence from the NutriNet-Santé e-cohort. J Hypertens 2021; 39:2422-2430. [PMID: 34261955 DOI: 10.1097/hjh.0000000000002941] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE An association between periodontitis and arterial hypertension has been suggested recently. This study aimed at investigating the hypothesis that periodontal health is linked to incident arterial hypertension. METHODS We analyzed data from the French population-based e-cohort NutriNet-Santé, selecting participants who had completed two oral health questionnaires in 2011-2012. Pregnant women, participants with diabetes, cancer, arterial hypertension and cardiovascular diseases at inclusion were excluded. Incident cases of arterial hypertension were self-reported and/or based on the use of antihypertensive therapy. Periodontal health was evaluated by estimating the modified and validated PEriodontal Screening Score (mPESS), with mPESS at least 5 corresponding to a high probability of severe periodontitis. Descriptive statistics and Cox proportional hazards regression models, taking into account sociodemographic and lifestyle confounders, were used. RESULTS The study population consisted of 32 285 participants (mean age: 45.79 ± 13.87 years); 78.5% were women. Two thousand one hundred and sixteen incident cases of arterial hypertension were identified during a median follow-up of 8 years (April 2012--December 2019). In the fully adjusted model, an mPESS at least 5 [hazard ratio: 1.84; 95% confidence interval (CI): 1.66-2.03] and the presence of nonreplaced missing teeth (hazard ratio: 1.13; 95% CI: 1.03-1.23) were significantly associated with a greater risk of incident arterial hypertension, whereas a regular annual visit to the dentist was associated with a lower risk (hazard ratio: 0.88; 95% CI: 0.80-0.97). CONCLUSION Self-reported assessed periodontitis was associated with incident arterial hypertension over an 8-year period. The present results highlight the importance of considering periodontal health when assessing an individual's risk of arterial hypertension. TRIAL REGISTRATION # NCT03335644.
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Moreira JPDL, Almeida RMVRD, Luiz RR. Accuracy of Self-Reported Arterial Hypertension in Brazil: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Lee S, Pantik C, Duggirala S, Lindquist R. A Comparison Between Self-Reported and Investigator-Measured Cardiovascular Risk-Related Biometric Numbers. West J Nurs Res 2021; 44:724-733. [PMID: 33955791 DOI: 10.1177/01939459211013580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine individuals' knowledge of cardiovascular risk-related biometric numbers and to compare self-reported and investigator-measured numbers in a convenience sample of adults in the Midwest region. Sociodemographic data and personal knowledge of cardiovascular risk-related biometric numbers were assessed using self-reported questionnaires. Investigators conducted health assessments to obtain biometric numbers. Among the 224 participants, participants' reported knowledge about their cardiovascular risk-related biometric numbers was low, especially for high-density lipoprotein and fasting blood glucose levels. Participants' knowledge was associated with education level and the recency of their last healthcare visit for health assessment. We found statistically significant mean differences between self-reported and investigator-measured blood pressure, and weight. This study found that there were discrepancies between self-reported and investigator-measured cardiovascular risk-related numbers. Future research is needed to develop educational interventions to improve personal knowledge of cardiovascular risks.
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Affiliation(s)
- Sohye Lee
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Catherine Pantik
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Sree Duggirala
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Ruth Lindquist
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Kislaya I, Leite A, Perelman J, Machado A, Torres AR, Tolonen H, Nunes B. Combining self-reported and objectively measured survey data to improve hypertension prevalence estimates: Portuguese experience. Arch Public Health 2021; 79:45. [PMID: 33827693 PMCID: PMC8028082 DOI: 10.1186/s13690-021-00562-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Accurate data on hypertension is essential to inform decision-making. Hypertension prevalence may be underestimated by population-based surveys due to misclassification of health status by participants. Therefore, adjustment for misclassification bias is required when relying on self-reports. This study aims to quantify misclassification bias in self-reported hypertension prevalence and prevalence ratios in the Portuguese component of the European Health Interview Survey (INS2014), and illustrate application of multiple imputation (MIME) for bias correction using measured high blood pressure data from the first Portuguese health examination survey (INSEF). METHODS We assumed that objectively measured hypertension status was missing for INS2014 participants (n = 13,937) and imputed it using INSEF (n = 4910) as auxiliary data. Self-reported, objectively measured and MIME-corrected hypertension prevalence and prevalence ratios (PR) by sex, age group and education were estimated. Bias in self-reported and MIME-corrected estimates were computed using objectively measured INSEF data as a gold-standard. RESULTS Self-reported INS2014 data underestimated hypertension prevalence in all population subgroups, with misclassification bias ranging from 5.2 to 18.6 percentage points (pp). After MIME-correction, prevalence estimates increased and became closer to objectively measured ones, with bias reduction to 0 pp - 5.7 pp. Compared to objectively measured INSEF, self-reported INS2014 data considerably underestimated prevalence ratio by sex (PR = 0.8, 95CI = [0.7, 0.9] vs. PR = 1.2, 95CI = [1.1, 1.4]). MIME successfully corrected direction of association with sex in bivariate (PR = 1.1, 95CI = [1.0, 1.3]) and multivariate analyses (PR = 1.2, 95CI = [1.0, 1.3]). Misclassification bias in hypertension prevalence ratios by education and age group were less pronounced and did not require correction in multivariate analyses. CONCLUSIONS Our results highlight the importance of misclassification bias analysis in self-reported hypertension. Multiple imputation is a feasible approach to adjust for misclassification bias in prevalence estimates and exposure-outcomes associations in survey data.
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Affiliation(s)
- Irina Kislaya
- Departament of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal.
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Andreia Leite
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Julian Perelman
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ausenda Machado
- Departament of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana Rita Torres
- Departament of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - Hanna Tolonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Baltazar Nunes
- Departament of Epidemiology, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
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Haleem A, Hwang YJ, Elton-Marshall T, Rehm J, Imtiaz S. The longitudinal relationship between cannabis use and hypertension. Drug Alcohol Rev 2021; 40:914-919. [PMID: 33644920 DOI: 10.1111/dar.13266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/24/2020] [Accepted: 02/04/2021] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The relationship between cannabis use and hypertension is not clear based on prior epidemiological studies. Thus, we examined this relationship over a 3-year follow-up period using a large population-based sample from the USA. METHODS Self-reported longitudinal data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 1 (2001/2002) and Wave 2 (2004/2005). The sample was restricted to participants who did not report hypertension at baseline (n = 26 844; 51% 40 years and older, 51% female, 71% white). χ2 -tests were used to examine the distributions of confounders stratified by the incidence of hypertension. Thereafter, multiple logistic regression analyses were conducted to quantify the relationships between lifetime cannabis use, 12-month cannabis use and 12-month cannabis use frequency and incidence of hypertension while adjusting for confounders. RESULTS Cannabis use was associated with a decreased incidence of hypertension in the unadjusted analyses. However, the relationships were confounded by age. After adjustment for all confounders, neither lifetime cannabis use (odds ratio, 95% confidence interval 0.89, 0.77 to 1.02), 12-month cannabis use (0.78, 0.56 to 1.09) nor 12-month cannabis use frequency [at least monthly use (0.85, 0.57 to 1.28) and less than monthly use (0.67, 0.40 to 1.11)] were associated above chance with the incidence of hypertension. DISCUSSION AND CONCLUSIONS Lifetime cannabis use, 12-month cannabis use and 12-month cannabis use frequency were not associated with the incidence of hypertension.
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Affiliation(s)
- Ahmed Haleem
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Yoseob Joseph Hwang
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Tara Elton-Marshall
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sameer Imtiaz
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
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Costa ÂK, Bertoldi AD, Fontanella AT, Ramos LR, Arrais PSD, Luiza VL, Mengue SS, Nunes BP. Does socioeconomic inequality occur in the multimorbidity among Brazilian adults? Rev Saude Publica 2021; 54:138. [PMID: 33331530 PMCID: PMC7703529 DOI: 10.11606/s1518-8787.2020054002569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/19/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To assess the prevalence of multimorbidity among Brazilian adults and its association with socioeconomic indicators. METHODS Cross-sectional study that used data from the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - Brazilian National Survey on Access, Use and Promotion of Rational Use of Medicines), carried out between 2013 and 2014. The definition of multimorbidity was the coexistence, in a single individual, of two or more chronic diseases, measured through a list of 14 morbidities (self-reported medical diagnosis throughout life). Economic status and educational level were the socioeconomic indicators used, being the inequalities assessed through the Slope Index of Inequality (SII) and the Concentration Index, stratified by gender. RESULTS The study comprehended 23,329 adults (52.8% of which were women), with an average age of 37.9 years. Hypertension and high cholesterol levels were the most prevalent conditions. The prevalence of multimorbidity was of 10.9% (95%CI 10.1-11.7) representing nearly 11 million individuals in Brazil, of which 14.5% (95%CI 13.5-15.4) were women and 6.8% (95%CI 5.9-7.8) were men. The occurrence of multimorbidity was similar according to the socioeconomic indicators. In the inequality analysis, we observed absolute and relative differences in men with a higher purchasing power (SII = 3.7; 95%CI 0.3-7.0) and higher educational level (CIX = 7.1; 95%CI 0.9-14.7), respectively. CONCLUSIONS The frequency of comorbidities in Brazilian adults is high, especially in absolute terms. We only observed socioeconomic inequalities in multimorbidities among men.
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Affiliation(s)
- Ândria Krolow Costa
- Universidade Federal de Pelotas. Faculdade de Enfermagem. Programa de Pós-Graduação em Enfermagem. Pelotas, RS, Brasil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Andréia Turmina Fontanella
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Luiz Roberto Ramos
- Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
| | | | - Vera Lucia Luiza
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Rio de Janeiro, RJ, Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Bruno Pereira Nunes
- Universidade Federal de Pelotas. Faculdade de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. Pelotas, RS, Brasil
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Bauwelinck M, Zijlema WL, Bartoll X, Vandenheede H, Cirach M, Lefebvre W, Vanpoucke C, Basagaña X, Nieuwenhuijsen MJ, Borrell C, Deboosere P, Dadvand P. Residential urban greenspace and hypertension: A comparative study in two European cities. ENVIRONMENTAL RESEARCH 2020; 191:110032. [PMID: 32814106 DOI: 10.1016/j.envres.2020.110032] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Living in green areas has been associated with several health benefits; however, the available evidence on such benefits for hypertension is still limited. This study aimed to investigate and compare the association between residential exposure to greenspace and hypertension in Barcelona, Spain and Brussels, Belgium. METHODS This cross-sectional study was based on data from the 2016 Barcelona Health Interview Survey (HIS) (n = 3400) and the 2013 Belgian HIS (n = 2335). Both surveys were harmonized in terms of outcomes, confounders and exposure assessment. Residential exposure to greenspace was characterized as 1) surrounding greenspace (normalized difference vegetation index (NDVI) and modified soil-adjusted vegetation index 2 (MSAVI2)) across buffers of 100 m, 300 m, and 500 m; 2) surrounding green space across 300 m and 500 m buffers; and 3) Euclidean distance to the nearest green space. Our outcome was self-reported hypertension. We developed logistic regression models to evaluate the city-specific association between each greenspace measure and hypertension, adjusting for relevant covariates. RESULTS One interquartile range (IQR) increase in residential distance to the nearest green space was associated with higher risk of hypertension in Barcelona [odds ratio (OR): 1.15; 95%CI 1.03-1.29 (IQR: 262.2)], but not in Brussels [OR: 0.95; 95%CI 0.77-1.17 (IQR: 215.2)]. Stratified analyses suggested stronger associations in older participants (≥65 years) for both cities. Findings for residential surrounding green space and greenspace were not conclusive. However, in Brussels, we found protective associations in older participants for both residential surrounding greenspace metrics [NDVI 300 m buffer OR: 0.51; 95%CI 0.32-0.81 (IQR: 0.21) and MSAVI2 300 m buffer OR: 0.51; 95%CI 0.32-0.83 (IQR: 0.18)]. We did not find any indication for the modification of our evaluated associations by sex and education level. CONCLUSION Our study suggests that living closer to greenspace could be associated with lower risk of hypertension, particularly in older age. Future research is needed to replicate our findings in other settings and shed light on potential underlying mechanism(s).
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Affiliation(s)
- Mariska Bauwelinck
- Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, 1050, Brussels, Belgium; Research Foundation - Flanders (FWO), 1000, Brussels, Belgium
| | - Wilma L Zijlema
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Xavier Bartoll
- Ag'ncia de Salut Pública de Barcelona, 08012, Barcelona, Spain; Institut de Recerca Biom'dica Sant Pau (IIB-Sant Pau), 08041, Barcelona, Spain
| | - Hadewijch Vandenheede
- Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Marta Cirach
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Wouter Lefebvre
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), 2400, Mol, Belgium
| | - Charlotte Vanpoucke
- Belgian Interregional Environment Agency (IRCEL-CELINE), 1030, Brussel, Belgium
| | - Xavier Basagaña
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Mark J Nieuwenhuijsen
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
| | - Carme Borrell
- Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain; Ag'ncia de Salut Pública de Barcelona, 08012, Barcelona, Spain; Institut de Recerca Biom'dica Sant Pau (IIB-Sant Pau), 08041, Barcelona, Spain
| | - Patrick Deboosere
- Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Payam Dadvand
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
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Calys-Tagoe B, Nuertey BD, Tetteh J, Yawson AE. Individual awareness and treatment effectiveness of hypertension among older adults in Ghana: evidence from the World Health Organization study of global ageing and adult health wave 2. Pan Afr Med J 2020; 37:264. [PMID: 33598079 PMCID: PMC7864259 DOI: 10.11604/pamj.2020.37.264.24526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/30/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION the aim of this study was to report the prevalence of hypertension, its awareness and treatment effectiveness among older adults (aged 50 years and above) in Ghana. METHODS the Ghana World Health Organization´s (WHO) Study on Global Aging and Adult Health (SAGE) wave 2 dataset was used in this study. The study adopted a cross-sectional study design. Information on self-reported hypertension as well as measured hypertension was analyzed. The level of awareness regarding hypertension and the effectiveness of treatment was determined using descriptive statistics. Factors associated with an individual´s awareness of their hypertensive status were determined using Rao-Scott Chi square test statistic and the predictors of unawareness of hypertension were determined using adjusted logistic regression analysis. A p-value of ≤0.05 was deemed significant. RESULTS information on 3,575 adults in Ghana aged 50 years or older was included in this analysis. The mean age of study participants was 65.1 ± 10.7 years with 59% being female. The prevalence of measured hypertension was 50.7% [95%CI=48.3-53.2]. The overall prevalence of hypertension among older adults in Ghana who were hypertensive but were not aware of it was 35.0% [95%CI=31.6-38.5]. Of the 332 individuals who self-reported being hypertensive, only 74 (22.2%) were on any form of treatment, with only 17 (5.1%) having their blood pressures well controlled. CONCLUSION approximately half of all older adults in Ghana have elevated blood pressures. Most of these are not aware of their elevated blood pressure and for those who are aware, very few are on treatment and even fewer have their blood pressure well controlled. Structured national population level screening and health promotion for elevated blood pressure by Ministry of Health/ Ghana Health Service is worthy of consideration.
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Affiliation(s)
- Benedict Calys-Tagoe
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Benjamin D Nuertey
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Garrigan H, Ifantides C, Prashanthi GS, Das AV. Biogeographical and Altitudinal Distribution of Cataract: A Nine-Year Experience Using Electronic Medical Record-Driven Big Data Analytics in India. Ophthalmic Epidemiol 2020; 28:392-399. [PMID: 33213243 DOI: 10.1080/09286586.2020.1849741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose: To use electronic medical record data to study the altitude, UV exposure, and biogeographical distribution of senile cataract in India.Methods: This is a hospital-based, cross-sectional study of patients over 40 years old with an ophthalmologist-confirmed diagnosis of senile cataract (cortical, nuclear, posterior subcapsular, or a combination) in either or both eyes. Electronic medical record data entered between August 2010 to December 2019 were extracted from a large multi-tiered ophthalmology network in India. Residential districts were classified into their respective biogeographical zone based on nationally reported boundaries, and altitude at the geographic centroid was determined using Google Earth. Occupations were classified as low UV exposure and high UV exposure. Descriptive statistics, hypothesis testing, and multiple logistic regression analysis were done.Results: In the 1,127,232 eligible patients, associations were found between high UV exposure (OR = 1.47, 95%CI: 1.45-1.49), low socioeconomic status (OR = 1.54, 95%CI: 1.52-1.55), rural geographies (OR = 1.32), female gender (OR = 1.33, 95%CI: 1.32-1.34), and older age (OR≥3.98) with cataract. This Indian patient population did not demonstrate increased formation of cataracts at higher altitudes (OR≤0.97). Patients residing in the Deccan Peninsula (OR≥1.56) and those with high UV exposures within each increasing altitude category, except >750 m, (OR≥1.09) had higher odds of senile cataract comparatively.Conclusion: Female gender, occupations with high UV exposure, rural geography and increasing age were observed to have greater odds of developing senile cataract. Increased likelihood of cataracts in populations residing at low altitudes and within the Deccan Peninsula may be attributed to greater hospital development in those areas.
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Affiliation(s)
- Hannah Garrigan
- Sidney Kimmel Medical College and College of Population Health, Thomas Jefferson University, Philadelphia, PA, USA
| | - Cristos Ifantides
- Department of Ophthalmology, University of Colorado/Denver Health, Denver, CO, USA
| | | | - Anthony Vipin Das
- Department of eyeSmart EMR & AEye, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Moreira AD, Gomes CS, Machado ÍE, Malta DC, Felisbino-Mendes MS. Cardiovascular health and validation of the self-reported score in Brazil: analysis of the National Health Survey. CIENCIA & SAUDE COLETIVA 2020; 25:4259-4268. [PMID: 33175035 DOI: 10.1590/1413-812320202511.31442020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022] Open
Abstract
This paper aims to estimate the prevalence of cardiovascular health and the validity of the Brazilian population's self-reported score. This is a cross-sectional, methodological study with 8,943 individual adults and laboratory data from the 2013 National Health Survey. We employed behavioral (body mass index, tobacco use, diet, physical activity, ideal if ≥ 3 ideal factors), biological (tobacco use, dyslipidemia, hypertension, and diabetes, ideal if ≥ 3 ideal factors), and cardiovascular health scores (all factors, ideal if ≥ 4 ideal factors). Prevalence of sensitivity and specificity scores and analyses of the self-reported scores were estimated, considering the scores with measured variables as the gold standard. Approximately 56.7% of individuals had ideal values for the measured cardiovascular health score. Sensitivity was 92% and specificity 30% for the self-reported biological score. Sensitivity and specificity scores were, respectively, 90.6% and 97.2% for self-reported behavior. The self-reported cardiovascular health score had a sensitivity of 92.4% and specificity of 48.5%. A little over half of the population had an ideal cardiovascular health score. The self-reported score showed good sensitivity and lower proportions of specificity.
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Affiliation(s)
- Alexandra Dias Moreira
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Crizian Saar Gomes
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Ísis Eloah Machado
- Escola de Medicina, Universidade Federal de Ouro Preto. Ouro Preto MG Brasil
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Mariana Santos Felisbino-Mendes
- Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Velasquez-Melendez G, Andrade FCD, Moreira AD, Hernandez R, Vieira MAS, Felisbino-Mendes MS. Association of self-reported sleep disturbances with ideal cardiovascular health in Brazilian adults: A cross-sectional population-based study. Sleep Health 2020; 7:183-190. [PMID: 33899744 DOI: 10.1016/j.sleh.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To examine the association between sleep disturbances and cardiovascular health in Brazilian adults. METHODS We analyzed cross-sectional data from a nationally representative sample of 36,480 Brazilian adults ages 18 and over. Multivariate Poisson regression models were used to assess the association between sleep disturbances (difficulty falling asleep, frequent interruptions in sleep, or sleeping more than usual) and Life's Simple 7 (LS7) cardiovascular health (CVH) scores through consideration of four behaviors (smoking, physical activity, body mass index, and diet) and three biological factors (hypercholesterolemia, hypertension, and diabetes). RESULTS Adults with no sleep disturbances had better CVH, with higher mean LS7 CVH scores (4.2, 95% confidence interval [CI]: 4.1; 4.2) when compared to those experiencing some level of sleep disturbance within a 2-week timespan (3.8, 95% CI: 3.7; 3.8). Specifically, compared to those with no sleep disturbance, adults reporting sleep disturbances for half of the weekdays had significantly lower LS7 CVH mean scores (β = -0.02, 95% CI: -0.04; 0.01). Adults who had disturbances more than half of the weekdays had even lower scores (β = -0.06, 95% CI: -0.09; -0.02), followed by those who reported disturbances almost every day (β = -0.08, 95% CI: -0.11; -0.04), even after adjusting for age, sex, education status, depressive symptoms, and night shift work. CONCLUSION Brazilian adults with sleep disturbances are less likely to achieve ideal CVH. Given that sleep disturbances seem to be increasingly common in Brazil, recent gains in CVH mortality may be affected.
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Affiliation(s)
- Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Alexandra Dias Moreira
- Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, USA
| | - Maria Alice Souza Vieira
- Graduate Program in Nursing, Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mariana Santos Felisbino-Mendes
- Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
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Guo H, Yu Y, Ye Y, Zhou S. Accuracy of Self-Reported Hypertension, Diabetes, and Hyperlipidemia among Adults of Liwan, Guangzhou, China. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:1622-1630. [PMID: 33643935 PMCID: PMC7898086 DOI: 10.18502/ijph.v49i9.4076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: We aimed to determine the accuracy of self-reported diabetes, hypertension, and hyperlipidemia in Chinese adults and examine factors that affect the accuracy of self-reports. Methods: This representative cross-sectional survey was conducted in Liwan District, Guangzhou City, Southeast China. Self-reported data were collected using a structured questionnaire. Biometrical data were recorded, including blood lipid, blood glucose and arterial blood pressure levels. Sensitivity, specificity, and κ values of self-reports were used as measurements of accuracy or agreements. The Robust Poisson-GEE was applied to determine the association of participants’ characteristics with the accuracy of self-reports. Results: Self-reported and biometrical data of 1278 residents aged 18 yr and older (693 women and 585 men) were used to calculate three measures of agreement. The agreement between self-reports and biomedical measurements was substantial for both hypertension and diabetes (κ=0.77 and 0.76), but only slight for hyperlipidemia (κ=0.06). Similarly, the sensitivity was higher for hypertension and diabetes (72.3% and 71.2%) than for hyperlipidemia (6.8%), while the specificity was high overall (≥98%). The factors associated with an accurate self-reported diagnosis in respondents with disease included having undergone blood pressure measurement (for hypertension) or blood glucose measurement (for diabetes) in the past 6 month, having attended health knowledge lectures in the past year and having social health insurances (for hypertension), and having undergone physical discomfort in the past 2 weeks (for hypertension and diabetes). Conclusion: The accuracy of self-reported hypertension and diabetes was high, whereas that of self-reported hyperlipidemia was lower among the population.
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Affiliation(s)
- Huijie Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, China.,Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yi Yu
- Guangzhou Liwan Center for Disease Control and Prevention, Guangzhou, 510176, China
| | - Yilu Ye
- Department of Psychiatry, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510700, China
| | - Shudong Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, China
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Altschul D, Starr J, Deary I. Blood pressure and cognitive function across the eighth decade: a prospective study of the Lothian Birth Cohort of 1936. BMJ Open 2020; 10:e033990. [PMID: 32709639 PMCID: PMC7380861 DOI: 10.1136/bmjopen-2019-033990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES We investigated the associations among blood pressure and cognitive functions across the eighth decade, while accounting for antihypertensive medication and lifetime stability in cognitive function. DESIGN Prospective cohort study. SETTING This study used data from the Lothian Birth Cohort 1936 (LBC1936) study, which recruited participants living in the Lothian region of Scotland when aged 70 years, most of whom had completed an intelligence test at age 11 years. PARTICIPANTS 1091 members of the LBC1936 with assessments of cognitive ability in childhood and older adulthood, and blood pressure measurements in older adulthood. PRIMARY AND SECONDARY OUTCOME MEASURES Participants were followed up at ages 70, 73, 76 and 79, and latent growth curve models and linear mixed models were used to analyse both cognitive functions and blood pressure as primary outcomes. RESULTS Blood pressure followed a quadratic trajectory in the eighth decade: on average blood pressure rose in the first waves and subsequently fell. Intercepts and trajectories were not associated between blood pressure and cognitive functions. Women with higher early-life cognitive function generally had lower blood pressure during the eighth decade. Being prescribed antihypertensive medication was associated with lower blood pressure, but not with better cognitive function. CONCLUSIONS Our findings indicate that women with higher early-life cognitive function had lower later-life blood pressure. However, we did not find support for the hypothesis that rises in blood pressure and worse cognitive decline are associated with one another in the eighth decade.
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Affiliation(s)
- Drew Altschul
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - John Starr
- Geriatric Medicine, Royal Victoria Hospital, Edinburgh, UK
| | - Ian Deary
- Department of Psychology, University of Edinburgh, Edinburgh, UK
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Suvila K, McCabe EL, Lima JAC, Aittokallio J, Yano Y, Cheng S, Niiranen TJ. Self-reported Age of Hypertension Onset and Hypertension-Mediated Organ Damage in Middle-Aged Individuals. Am J Hypertens 2020; 33:644-651. [PMID: 32227078 PMCID: PMC7368170 DOI: 10.1093/ajh/hpaa055] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/26/2020] [Accepted: 03/26/2020] [Indexed: 01/19/2023] Open
Abstract
Background Objectively defined early onset hypertension, based on repeated blood pressure measurements, is a strong risk factor for cardiovascular disease (CVD). We aimed to assess if also self-reported hypertension onset age is associated with hypertension-mediated organ damage (HMOD). Additionally, we evaluated the agreement between self-reported and objectively defined hypertension onset age. Methods We studied 2,649 participants (50 ± 4 years at the time of outcome assessment, 57% women) of the Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent measurements for echocardiographic left ventricular hypertrophy (LVH), left ventricular diastolic dysfunction (LVDD), coronary calcification, and albuminuria. We divided the participants into groups according to self-reported hypertension onset age (<35 years, 35–44 years, ≥45 years, and no hypertension). We used multivariable-adjusted logistic regression models to assess the relation between self-reported hypertension onset age with the presence of HMOD, with those who did not report hypertension as the referent group. Results Compared with individuals without self-reported hypertension, self-reported hypertension onset at <35 years was associated with LVH (odds ratio (OR), 2.38; 95% confidence interval (CI), 1.51–3.76), LVDD (OR, 2.32; 95% CI, 1.28–4.18, coronary calcification (OR, 2.87; 95% CI, 1.50–5.47), and albuminuria (OR, 1.62; 95% CI, 0.81–3.26). Self-reported hypertension onset at ≥45 years was only associated with LVDD (OR, 1.81; 95% CI, 1.06–3.08). The agreement between self-reported and objectively defined hypertension onset age groups was 78–79%. Conclusions Our findings suggest that self-reported hypertension onset age, a pragmatically feasible assessment in clinical practice, is a reasonable method for assessing risk of HMOD and CVD.
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Affiliation(s)
- Karri Suvila
- Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Elizabeth L McCabe
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Joao A C Lima
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jenni Aittokallio
- Division of Perioperative Services, Turku University Hospital and University of Turku, Turku, Finland
| | - Yuichiro Yano
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | - Susan Cheng
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Teemu J Niiranen
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Turku, Finland
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Nilsson U, Mills NL, McAllister DA, Backman H, Stridsman C, Hedman L, Rönmark E, Fujisawa T, Blomberg A, Lindberg A. Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease. Respir Res 2020; 21:162. [PMID: 32590988 PMCID: PMC7318493 DOI: 10.1186/s12931-020-01430-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively. Methods In 2002–04, all individuals with airway obstruction (FEV1/VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010. Results Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46–5.07 and 4.54; 2.25–9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease. Conclusions In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.
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Affiliation(s)
- Ulf Nilsson
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University Hospital, B41, 90185, Umeå, Sweden.
| | - Nicholas L Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | | | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Caroline Stridsman
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, The OLIN unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, The OLIN unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Takeshi Fujisawa
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University Hospital, B41, 90185, Umeå, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University Hospital, B41, 90185, Umeå, Sweden
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Wellman JL, Holmes B, Hill SY. Accuracy of self-reported hypertension: Effect of age, gender, and history of alcohol dependence. J Clin Hypertens (Greenwich) 2020; 22:842-849. [PMID: 32277600 DOI: 10.1111/jch.13854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 11/26/2022]
Abstract
Patient awareness of medical conditions may influence treatment seeking and monitoring of these conditions. Accurate awareness of hypertension reported to clinicians evaluating patients for whom clinical history is limited, such as in emergency care, can aid in diagnosis by revealing whether measured hypertension is typical or atypical. Measurement of blood pressure in a laboratory study was assessed at rest, immediately before phlebotomy, and within 10 minutes after. The resting measure was used to determine the accuracy of self-reported hypertension in 283 adults. Parametric analyses were conducted to identify potential variables influencing accuracy of self-reported hypertension. Sensitivity, specificity, and the kappa coefficient of agreement were calculated to determine the influence of alcohol dependence (AD), sex, age, and cigarette smoking on hypertension awareness. Self-report was mildly sensitive, correctly identifying individuals with hypertension in approximately 37% of the cases, but was highly specific (95%) in identifying individuals without hypertension. Similar sensitivities were found in analyses separated by sex. Sensitivity was greater in those over age 55 (53%) in comparison with those <54, as well as in those who were not smoking. Comparison of those with and without a history of AD revealed that both groups show similar accuracy in reporting hypertension. Absence of hypertension can be accurately determined with self-report data in those without hypertension. A significant proportion of those with measured hypertension report an absence of hypertension.
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Affiliation(s)
| | - Brian Holmes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shirley Y Hill
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Haff N, Lauffenburger JC, Morawski K, Ghazinouri R, Noor N, Kumar S, Juusola J, Choudhry NK. The accuracy of self-reported blood pressure in the Medication adherence Improvement Support App For Engagement-Blood Pressure (MedISAFE-BP) trial: Implications for pragmatic trials. Am Heart J 2020; 220:68-72. [PMID: 31785551 DOI: 10.1016/j.ahj.2019.10.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/30/2019] [Indexed: 11/26/2022]
Abstract
Self-report of health conditions and behaviors is one potential strategy to increase the pace of enrollment into pragmatic clinical trials. In this study, we assessed the accuracy of self-reported poorly controlled hypertension among adults in the community who were screened for participation in the MedISAFE-BP trial. Of individuals who self-reported poorly controlled hypertension using the online trial enrollment platform, 64% had a systolic blood pressure less than 140 mm Hg when measured at home. Although we identified several characteristics associated with accurate self-report including older age (odds ratio [OR] 1.02 per year, 95% CI 1.01-1.03), diabetes (OR 1.59, 95% CI 1.17-2.14), and low health activation (OR 1.56 95% CI 1.17-2.07), we were unable to identify patients for whom self-reported hypertension would be a reliable method for their inclusion in a pragmatic trial.
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Hypertension prevalence in patients attending tertiary pain management services, a registry-based Australian cohort study. PLoS One 2020; 15:e0228173. [PMID: 31978196 PMCID: PMC6980551 DOI: 10.1371/journal.pone.0228173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/08/2020] [Indexed: 12/20/2022] Open
Abstract
Persistent pain and hypertension often co-occur, and share several biological and lifestyle risk factors. The present study aimed to provide insight into the prevalence of, and factors associated with, hypertension in the largest cohort of patients seeking treatment in 43 tertiary pain clinics in Australia. Adults aged > = 18 years registered to the electronic Persistent Pain Outcomes Collaboration registry between 2013 and 2018 were included if they had persistent non-cancer pain (N = 43,789). Risk Ratios (RRs) compared prevalence of self-reported hypertension with the general and primary care Australian populations, and logistic regression examined factors associated with hypertension. One in four (23.9%) patients had hypertension, which was higher than the Australian adult population (2014–15: RR = 5.86, 95%CI: 5.66, 6.06; 2017–18: RR = 9.40, 95%CI: 9.01, 9.80), and in primary care patients (2011–13: RR = 1.17, 95%CI: 1.15, 1.20). Adjusting for covariates, patients with higher odds of hypertension were older, lived in regions with higher socioeconomic disadvantage, had higher levels of BMI, were born outside the Oceania/Australasia region, and had comorbid arthritis, diabetes, or severe-extremely severe anxiety symptoms. Female patients and those with depression symptoms had lower adjusted odds. Unadjusted analyses showed an association between widespread pain, pain duration, pain severity and interference, and lower pain self-efficacy with hypertension; however, only pain severity remained significant in adjusted analyses. Hypertension was more prevalent in people with persistent pain than in the general community, was associated with more severe pain, and commonly co-occurred with pain-related impairments. Routine hypertension screening and treatment targeting shared mechanisms of hypertension and pain may improve treatment outcomes in the pain clinic setting.
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Moreira JPDL, Almeida RMVRD, Rocha NCDS, Luiz RR. Prevalence of corrected arterial hypertension based on the self-reported prevalence estimated by the Brazilian National Health Survey. CAD SAUDE PUBLICA 2020; 36:e00033619. [DOI: 10.1590/0102-311x00033619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/09/2019] [Indexed: 11/21/2022] Open
Abstract
The objective was to correct the self-reported prevalence of systemic arterial hypertension (SAH) obtained from the Brazilian National Health Survey (PNS 2013). SAH prevalence estimates were corrected by means of sensitivity/specificity of information. Sensitivity and specificity values from a similar study (same self-report question, age range and gold standard) were used to this end. A sensitivity analysis was also performed, by using the upper and lower limits of confidence intervals as sensitivity and specificity parameters. The corrected prevalence of SAH for Brazil as a whole was 14.5% (self-reported: 22.1%). Women presented a higher rate of self-reported SAH but, after correction, men were found to have a higher prevalence. Among younger women (18-39 age range), the self-reported prevalence was 6.2%, a value that, after correction, dropped to 0.28%. There was not much difference between self-reported and corrected SAH among the elderly (51.1% vs. 49.2%). For certain groups the corrected results were greatly different from the self-reported prevalence, what may severely impact public health policy strategies.
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Altschul DM, Wraw C, Der G, Gale CR, Deary IJ. Hypertension Development by Midlife and the Roles of Premorbid Cognitive Function, Sex, and Their Interaction. Hypertension 2019; 73:812-819. [PMID: 30776973 PMCID: PMC6426348 DOI: 10.1161/hypertensionaha.118.12164] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Higher early-life cognitive function is associated with better later-life health outcomes, including hypertension. Associations between higher prior cognitive function and less hypertension persist even when accounting for socioeconomic status, but socioeconomic status-hypertension gradients are more pronounced in women. We predicted that differences in hypertension development between sexes might be associated with cognitive function and its interaction with sex, such that higher early-life cognitive function would be associated with lower hypertension risk more in women than in men. We used accelerated failure time modeling with the National Longitudinal Study of Youth 1979. Cognitive function was assessed in youth, when participants were aged between 14 and 21 years. Of 2572 men and 2679 women who completed all assessments, 977 men and 940 women reported hypertension diagnoses by 2015. Socioeconomic status in youth and adulthood were investigated as covariates, as were components of adult socioeconomic status: education, occupational status, and family income. An SD of higher cognitive function in youth was associated with reduced hypertension risk (acceleration factor: ĉ=0.97; 95% CI, 0.96-0.99; P=0.001). The overall effect was stronger in women (sex×cognitive function: ĉ=0.97; 95% CI, 0.94-0.99; P=0.010); especially, higher functioning women were less at risk than their male counterparts. This interaction was itself attenuated by a sex by family income interaction. People with better cognitive function in youth, especially women, are less likely to develop hypertension later in life. Income differences accounted for these associations. Possible causal explanations are discussed.
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Affiliation(s)
- Drew M Altschul
- From the Department of Psychology (D.M.A., C.W., I.J.D.), University of Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom
| | - Christina Wraw
- From the Department of Psychology (D.M.A., C.W., I.J.D.), University of Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom
| | - Geoff Der
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom (G.D.)
| | - Catharine R Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, United Kingdom (C.R.G.)
| | - Ian J Deary
- From the Department of Psychology (D.M.A., C.W., I.J.D.), University of Edinburgh, United Kingdom.,Centre for Cognitive Ageing and Cognitive Epidemiology (D.M.A., C.W., C.R.G., I.J.D.), University of Edinburgh, United Kingdom
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